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Head injury in the child
Published in Helen Whitwell, Christopher Milroy, Daniel du Plessis, Forensic Neuropathology, 2021
Helen Whitwell, Christopher Milroy
With increasing age of the child, the findings are essentially those seen in the adult with surface contusional/lacerating injury. In the younger infant, the ‘adult-type’ contusional injury is not a common finding, although if present it is most frequently seen in the olfactory bulbs or tracts and gyrus rectus (Rorke 1992). In severe trauma associated with fracture, true coup contusions relating to the fracture site may be seen. The various types of intracerebral haematoma seen are covered in Chapter 8.
The Relation of Alcohol-Induced Brain Changes to Cognitive Function
Published in Jenny Svanberg, Adrienne Withall, Brian Draper, Stephen Bowden, Alcohol and the Adult Brain, 2014
Beaunieux Hélène, Eustache Francis, Pitel Anne-Lise
Several regions belonging to the somatic marker brain network are known to be damaged in chronic alcoholism, especially the frontal cortices, amygdala, hippocampus, striatum and cerebellum. Le Berre et al. (2014) reported that decision-making deficits in alcoholism are associated with reduced gray matter volume in the ventromedial prefrontal cortex (gyrus rectus and pregenual anterior cingulate cortex), the dorsal portion of the anterior cingulate cortex and the hippocampal formation (Figure 8.6). These results suggest that decision-making deficits in this group may result from impairment of both impulsive and reflective brain networks. These deficits may lead people with alcoholism to suffer from “myopia” for the future, contributing to their tendency to choose instant gratification (i.e., the immediate advantages of their alcohol consumption). This “myopia” may dim the person's awareness of the problems arising from substance abuse and may keep them in denial about their illness (Verdejo-García and Pérez-García, 2008).
Brain regions, lesions, and stroke syndromes
Published in Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees, Stroke in Practice, 2017
Christos Tziotzios, Jesse Dawson, Matthew Walters, Kennedy R Lees
The frontal lobe contains centres for motor control of the opposite side of the body, insight and control of emotions, and output of speech in the dominant hemisphere. The precentral gyrus (seeFigure 3.2 in the plate section) lies in front of the central sulcus (the boundary of the frontal lobe) and contains the primary motor cortical area, which exerts control over fine voluntary movements on the contralateral side in a somatotopic fashion as depicted by the motor homunculus (seeFigure 3.3 in the plate section). A stroke lesion here would lead to contralateral weakness at the relevant site. The premotor cortex, just anteriorly to the primary motor cortex, plays a role in controlling functionally related groups of muscles. Further anteriorly lies the frontal eye field, responsible for voluntary conjugate deviation of the eyes; impairment of this very lesion will result in deviation of the eyes toward the side of the lesion. The motor speech area of Broca is in the vicinity of the lateral sulcus of the dominant hemisphere (usually left); a lesion herein would produce expressive dysphasia. The prefrontal cortex has important intellectual and behavioural functions, including the judging, predicting, planning, and evaluating faculties. Naturally, this convoluted role is facilitated by a rich network of interconnections between the prefrontal cortex and other brain regions. Lesions in this area can have a profound impact on aspects of human behaviour. On the inferior aspect of the frontal lobe, within its orbital surface, lies the gyrus rectus with the olfactory bulb, responsible for the sense of smell.
Treatment of posttraumatic olfactory dysfunction with corticosteroids and olfactory training
Published in Acta Oto-Laryngologica, 2020
Mette Bratt, Kent G. Moen, Ståle Nordgård, Anne-S. Helvik, Toril Skandsen
MRI of the brain had been performed at a median of 35 d (range 3–528 d) after injury in 20/23 patients in a 1.5-T Siemens Symphony or a Siemens Avanto MR imaging system (Siemens Medical) using a standard clinical protocol including diffusion weighted imaging, T2*-weighted gradient echo imaging and FLAIR imaging. For more details, see a previous publication [18]. One of the co-authors (K.G.M.) reviewed the MRI scans for orbitofrontal lesions. Orbitofrontal lesions were defined as contusions or traumatic axonal injury located in the medial, lateral, anterior and posterior orbital gyrus as well as in the gyrus rectus. The surgical interventions registered were: (1) Mass lesion evacuation (epidural, subdural or intracerebral hematomas or large contusions) and (2) surgery due to facial fracture or soft tissue damage; registered with a yes or no response.
Hemifield-slide diplopia successfully managed with botulinum toxin injection in a patient with traumatic chiasmal disruption
Published in Clinical and Experimental Optometry, 2022
Kaveh Abri Aghdam, Ali Aghajani, Faeze Hashemi Rahbarian, Mostafa Soltan Sanjari
Magnetic resonance imaging revealed an anterior skull base fracture extended from the frontal sinus to the ethmoid and sphenoid sinuses. Extensive brain oedema, downward shifting of the left gyrus rectus into the left ethmoid sinus, and disruption of chiasmal structure prominently in its anterior part were observed (Figure 1). No surgical intervention was performed at that time and the patient was discharged after receiving intravenous pulse methylprednisolone (1 g/day for three days).