♦ Gage had no weakness but underwent a
personality change from solid and
dependable to “fitful, irreverent and grossly
Reconstruction of Gage Injury
♦ The brain is an amazing and complex
instrument that is not well understood.
Goals and Objectives
♦ Goal: To gain an appreciation of the range
of disorders affecting the human brain
– To become familiar with categories of brain
– To become familiar with features of these
– To learn about some specific examples of
disorders in each category
A healthy 25 year-old engineer lost his
ability to read over a period of months. He
was found to have encephalitis, and over a
treatment period of 2 years finally returned
Tumor patients usually have worsening
headaches, and possible weakness or
numbness. Alternatively patients may come
in with a seizure.
♦ “Primary” – start in the brain
– On the surface of the brain (meningiomas)
– Inside the brain (gliomas) (like Kennedy)
♦ “Secondary” – travel to the brain
– Metastatic cancer
♦ Teddy Kennedy recently had a seizure. He
was found to have a large brain tumor. He
has received surgery and possible radiation
and remains in the Senate.
♦ Epilepsy is the tendency to have seizures
(uncontrolled electrical brain activity).
People with epilepsy may suddenly have
staring spells or shaking spells or they may
just “fall out.”
♦ Focal seizures (involve part of the brain)
♦ Generalized seizures (involve the whole
♦ A young girl started doing poorly in school.
Her teacher noted increased staring spells
and less participation in class. She was
found to have seizures and did fine after
♦ A 19 year-old girl was admitted to Shock-
Trauma after being involved in a car
accident. She was in a coma for 3 weeks
and then woke up after going to a rehab
center. She is now home and back to work.
Chemical (metabolic): Features
♦ Chemical disturbances generally affect
people’s thinking, leading to confusion or
sleepiness within a short period of time.
Chemical (metabolic): Types
♦ Salt imbalance (electrolyte imbalance)
♦ Hormone problems (glandular)
♦ Nutrition problems
♦ Drug intoxications
Chemical (metabolic): Case
A 60 year-old man with longstanding
alcohol abuse is brought to the emergency
room because he is agitated, confused and
feeling that bugs are crawling on him.
♦ Children who are born with strokes, genetic
conditions, or infections can have problems
with their development.
Developmental Disorder: Case
♦ A 4 year-old boy had problems getting
along with others at pre-school. He made
poor eye contact and began getting upset
when anyone disturbed the layout of his
Degenerative Disorders: Features
♦ Degenerative conditions generally involve
the slow loss of skills such as thinking,
walking over years
Degenerative Disorder: Case
My father did masonry, tailoring, etc., until
he began losing his memory at 66. He was
eventually diagnosed with Alzheimer’s
Disease. He slowly lost the ability to work,
drive, and even talk, despite treatment.
♦ The brain is a wonderful organ!
♦ The brain is a complex organ!
♦ The brain is understandable.
♦ The brain is not well understood!