Question

2. Case Study: 39-year old female with Traumatic Brain Injury Margaret Bryans, a 39-year old female, lost control while skiing and hit her head on a tree (she was not wearing a helmet). She regained consciousness en route to the hospital and appeared agitated and combative. Paramedics observed that she had muscle weakness on her right side with a nearly complete paralysis of her right upper extremity and a partial paralysis of her right lower extremity. A head CT scan revealed an acute subdural hematoma and an extensive subarachnoid hemorrhage. Doctors noted that she could feel pressure, touch, and pain in all extremities when tested, and she was able to follow commands from medical personnel. Her blood pressure, breathing rate, and heart rate were normal, but she could only speak haltingly, using simple words. Surgery was performed to remove large clots from the subarachnoid space immediately. Two weeks after the surgery, she showed significant improvement in her speech and motor function. a. What is a subdural hematoma? What is a subarachnoid hemorrhage? Point to where these would be located on a diagram. b. The adult brain consists of 4 regions. Name them. Based on the observed signs in this case, which of these four brain regions is involved? What evidence did you use to determine this? c. Which specific part(s) of the region identified in #2 was/were involved so as to cause muscle weakness and speech problems? d. Ms. Bryan's subdural and subarachnoid bleeding most likely interfered directly with which of the following? You can choose more than one. a. The blood supply to the scalp b. The blood supply to the cerebral cortex C. Pressure in the cranium d. The removal of cerebrospinal fluid e. The creation of cerebrospinal fluid Imagine that when Ms. Brian regained consciousness, she began vomiting uncontrollably, she lost consciousness again, and her breathing became irregular. What part(s) of her brain do you think are involved now? What do you think is happening to her brain to cause this result?

Answer 1

Ans-1 8ubdural hematoma It is a torm ot traumatic brain injury which blond gathers between the dura & the arachnoidmatter in tAns-2 Subarachnoid hemorrhaye 1tisthe bleda into the gubarachaoid Space within the lntracranial vault cdns-3 Four regions of the brain iy Cerchrum lasgest Section et the brain -Located in the lipper por tion of the brain & is the area that piocesscass thoughts judgement problem solving laguage imaginatens memory -consis of cercbral cortex-Superhicial layea ceicbnum is subdivided urda the left ight hemisphere -Lobes of cexebium :Frontal, paaictal, temporal ocipital

21 Cexebellum -located beneath the postenioy paat of the cerebrum -Aids in toordinatiny voluatay body movenents mainatainthg balance eilibrin ii Brain tem consist of Midbrain Pons Med ulla oblongata Midbiain:-acts as a pathway for impula to be conducted between brain 'spinal cord Connects the cesebellum to the rcst of Pons the brain Deals with respiration, suallowing bladder cantrol heaning sequilibrium eye expresioni Medulla oblangata 'sihuated at the base at the Skull Lonsist of regulatory centres like casdiovas cdlan, shytnicity,vasoma to i Diencephalon posteniar pad brain consist of thalanus, hypothalamas Epithalamus pincal gland

3 edns-4 Ceseb um is atteched ds pretsontal cortey /forebrain consistof Broca's areas which is a8peech arca patient has a problem in specch Ans s The twa aseas ot the brain asA acialed with language Brocas & wennickes areas are locatid dh the lett cerebyal cortey 9the motor dyskuntrion en the ngt side suggest #hat the injusy has attected the primanymotor cortex gthe premotos. cortex of the left cesebral hemisphere option- (b) Subduralsubarachnaid blecding likely intertered directly with the Bland to the cerebral cortex dns-6 most supply