Brain Injury Medicine E-Book

Board Review

Blessen C. Eapen, David X. Cifu, Blessen Eapen, Blessen Eapen, David X. Cifu

• Publisher: Elsevier
• Year: 2020
• Print ISBN: 9780323653855
• eBook ISBN: 9780323779449
• Topic: Medicine
• Subtopic: Neurology

The only review book currently available in this complex field, Brain Injury Medicine: Board Review focuses on the prevention, diagnosis, treatment, and management of individuals with varying severity levels of brain injury. Focused, high-yield content prepares you for success on exams and in practice, with up-to-date coverage of traumatic brain injury (TBI), stroke, CNS neoplasms, anoxic brain injury, and other brain disorders. This unique review tool is ideal for residents, fellows, and practitioners studying or working in the field and preparing to take the brain injury medicine exam.- Supports self-assessment and review with 200 board-style questions and explanations.- Covers the information you need to know on traumatic brain injury by severity and pattern, neurologic disorders, systemic manifestations, rehabilitation problems and outcomes, and basic science.- Includes questions on patient management including patient evaluation and diagnosis, prognosis/risk factors, and applied science.- Discusses key topics such as neurodegeneration and dementia; proteomic, genetic, and epigenetic biomarkers in TBI; neuromodulation and neuroprosthetics; and assistive technology.- Reviews must-know procedures including acute emergency management and critical care; post-concussion syndrome assessment, management and treatment; diagnostic procedures and electrophysiology; neuroimaging, and brain death criteria.- Ensures efficient, effective review with content written by experts in physical medicine and rehabilitation, neurology, and psychiatry and a format that mirrors the board exam outline.

Section 1:

Brain Anatomy and Physiology

Outline

• 1. Neuroanatomy correlates
• 2. Basic brain neuroscience and pathophysiology

1: Neuroanatomy correlates

Jason R. Soble, PHD, ABPP-CN, Samantha Dedios-Stern, PHD, David Andrés González, PHD, ABPP-CN, K. Chase Bailey, PHD, ABPP-CN

Abstract:

This chapter provides a foundational overview of basic structural and functional neuroanatomy as relevant in the context of brain injury. It includes a review of the general organization of the brain with specific elucidation of the pertinent cortical and subcortical structures that underlie key human cognitive, emotional, and behavioral functions. Specifically, the skull and meninges, cranial nerves, brainstem, cerebellum, and four paired lobes comprising the cerebral cortex are discussed, along with the vasculature and cerebrospinal fluid systems. Finally, the functional brain connectivity and associated pathways underlying aspects of higher order human neurobehavioral abilities (e.g., vision, language, memory) are outlined.

Keywords:

Functional neuroanatomy

structural neuroanatomy

brain injury

cerebral cortex

human cognition

Outline

• Structural Organization of the Brain
  • Skull and Meninges
  • Vasculature
  • Cerebrospinal Fluid System
  • Brainstem
  • Cranial Nerves
  • Cerebellum
  • Cerebrum
    • Frontal Lobes
    • Temporal Lobes
    • Parietal Lobes
    • Occipital Lobes
  • Subcortical Structures
    • Thalamus
    • Hypothalamus and Pituitary Gland
    • Epithalamus/Subthalamus
    • Basal Ganglia
• Functional Brain Connectivity/Pathways
  • Sensory-Motor
  • Attention/Arousal
  • Vision/Visuoperception
  • Language/Speech
  • Memory
  • Frontal-Subcortical Circuitry

This chapter provides a foundational overview of basic structural and functional neuroanatomy relevant to brain injury. As such, the coverage is not exhaustive, and the reader is referred to authoritative texts^1-3 for more comprehensive detail. Moreover, although descriptive, the summary of each neuroanatomical structure/connection is not prescriptive, in that similar structural lesions can result in strikingly diverse functional neurobehavioral presentations among individual patients.^4-5 Finally, neuroanatomical structures and associated functions are presented as discrete units here for review, but the human brain is a highly complex, connected, and integrated organ such that lesions rarely produce a singular functional deficit.

Structural organization of the brain

The command center of the human CNS, the brain is enclosed in the skull and meninges and structurally divided into the brainstem, cerebellum, and cerebrum. Beneath the cerebral cortex lie several key subcortical structures and connective pathways. The brain is made up of gray matter (cell bodies), which comprises the cortex and some subcortical structures (e.g., basal ganglia), and myelinated white matter, which transmits information to and from connected gray matter for integration/processing. The cortex is folded to allow for greater surface area within the skull, which produces its characteristic grooves (sulci) and folds (gyri). Cardinal directions and key landmarks within the brain are summarized later (Box 1.1; Figs. 1.1 and 1.2).

• BOX 1.1

Summary of Cardinal Directions and Key Landmarks in the Brain

Anterior (rostral)	Toward the front
Posterior (caudal)	Toward the back
Dorsal	Toward the top
Ventral	Toward the bottom
Medial	Toward the middle
Lateral	Toward the side
Precentral (pre-Rolandic)	In front of the central sulcus (Rolandic fissure)
Postcentral (post-Rolandic)	Behind the central sulcus (Rolandic fissure)
Perisylvian	Around the Sylvian fissure (lateral sulcus)
Forebrain	Cerebral cortex, thalamus, and hypothalamus
Hindbrain	Brainstem and cerebellum

Skull and meni...

Table of contents

• Cover image
• Title page
• Table of Contents
• Copyright
• Dedication
• Contributors
• Preface
• Acknowledgements
•     List of Tables
•     List of Illustrations
• Section 1. Brain Anatomy and Physiology
• Section 2. Traumatic Brain Injury Severity and Patterns
• Section 3. Epidemiology and Risk Factors
• Section 4. Emergency Room and Intensive Care Management
• Section 5. Evaluation and Diagnosis
• Section 6. Complications and Management
• Section 7. Rehabilitation Concepts
• Section 8. Special Topics
• Answer key
• Answer key
• Index