• Frontal lobe: silvian fissure and central sulcus are the boundaries, motor strip, premotor, evecutive function
• Temporal: temporal occipital pole, heschels gyrus, aduitory association
• Parietal: sensory strip, sensory association, agnosia
• Occipital: vision, primary visual and association areas

• Hippocampus: memory, subcortical grey matter, long term memory, 1st structure affected with AD
• Amygdala: emtion, if lesion tend to be flat
• Thalamus: automatic fucnton, reley station, controls consciousness (working and sleeping)
• Hypothalamus: vegitative functions, bodies themostate
• Fornix: connection between hypothalamus and thalamus

• Subcortical grey
• not in the lobes
• thalamus
• BG: caudate nucleus, putament, globus pallidus, amygdala, motor function, Parkinson's
• Subcortical white
• connections
• corpus collosum
• arculate fasiculus

• Veterbral system and its branches (posterior)
• Internal Carotid and its branches (medial and anterior)
• Circle of Willis

• 2 VAs course through the neck and enter the brain via the foraman magnum
• lie on the anterior/ventral surface of the medulla
• give off branchs called the posterior cerebellar arteries (PICA) to supply the medulla
• 2 VAs come together to make up Basilar Artery
• BA gives off 2 pairs of large artery branches

• Anterior inferior cerebellar arteries: supply the medulla, pons, cerebellum, and inner ear
• Superior cerebellar arterires: supply the superior surface of the cerebellum
• problems with balance and equalibrium
• If problem low enough on BA have locked in syndrome

• BA forms 2 posterior cerebral arteries (PCA) at the upper pons
• PCAs feed the posterior portions (occipitals and temporal lobe)
• smaller posterior communicating arteries (PCoA) connect the PCAs to the internal carotid

• Come through the neck, not as protected
• join the PCA via communicating arteries
• largest branch of the ICA continues as the middle cerebral artery (MCA)

• follows the lateral sulcus/sylvian fissure
• supply the lateral surface of the brain (front, parietal, and temporal)
• supply subcortical regions (thalamus, BG)

• MCA gives off 2 branchs called the anterior cerebral arteries (ACA)
• ACA feed the medial surfaces of the frontal, parietal, and corpus callosum
• Conneted to each other via the anterior communicating artery (ACoA)

• joins the veterbral and carotid
• provide a safety valve or alternate route if artery is blocked
• blood can flow in either direction

• PCA
• PCoA
• ICA
• ACA
• ACoA
• BE ABLE TO LABLE COW

• cerebrovascular accident
• a disturbance in brain function resulting from vascular disruption
• signs: unilateral weakness/numbness, visual disturbances, difficultly communicating, dizziness, severe headache

• Ischemic: account for 80% of CVAs, result in an occlusion or blockage in blood flow
• Hemmoragic: 20% and result from excessive blood flow, usually more devistative, covers a larger area, recover more slowly because need time to absorb blood

• 60%
• stationary bloackage assosciated with ASCVD
• incidious onset, ministraokes, dizziness, blurred vision, tingling in extermeties
• dopolar studies to look at artries to see how much blood supply is gettting through
• CEA = carotid endardectomy
• high cholestrol leads to plaque build up

• embolism
• 20%
• blockage from foregin migration into smaller vessels
• abrupt onset
• usually comes from heart of lung
• PE = pulmonary embolism
• DVT = deep vein thrombosis
• due to be stationary for too long

• neuron necrosis (tissue death)
• edema with increased cranical pressure- may lead to skull being removed to allow for brain to sweel 
• absesce of neurotransmitor slow
• diachisis- deficits futher away from lesion
• collateral sprouting: leads to spnataneous recovery sometimes, stronger in youngr pop

• 20%
• extra: usually in meniges, EDH = extra dural hematona
• SDH= subdural hematoma, occurs when people fall because a lot of blood there so suseptable to falls
• SAH = sub arachnoid, common cause is TBI
• intracerebelar classification 
• linked to hypertension (HTN)
• not many options, only due surgury if really serious
• weak wall ruptures due to increaed blood pressure
• abrupt or incidious onset possible
• aneurysm
• AVM

• Neuro stablization first 2 weeks
• fuction recovery greatest at 4 wks
• lang recovery greatest up to 3 month
• neuro recover 6 months post onset
• mid range patients exhibit the greatest improvement because not too much to recovery from

• slow imprvements in the first 2 month but rapid improvements followed
• recovery anticipated 6 months post onset because blood need to be reabsirbed

• Insult issues
• location, size, diachisis, secondary factors
• Patient issues
• ages, handedness, hemispheric dominence, premorbid profile
• location and deficits
• frontal: less inhibited
• premotor: motor planning
• motor: paraylsis
• auditory: deafness

• primary (found in brain) secondary (breast and colon tumor lead to brain tumor)
• ages 25 to 50
• gliomas (most common)
• astrocytomes: more benign, slow growth, do better
• glioblastoma: most malignant, worst tumor 2 yr life expectancy
• meningiomas: slow growth, mixed rates for survival
• assess pre-op to determine deficits before surgury
• Herniation secondary to edema (with good management can be avoided)

herniation

• divides cerebrum from cerebellm, brain breaks through tenterium, very bad
• mass effect, increase ICP
• extreme measures required
• large bleed brain gets shifted past midline, no longer symmetry so leads to increased ICP

• enlarged ventricels from ICP or atrophy
• obstructive vs non obstructive (doesnt get absorbed)
• lethargy, reduced responsiveness, cog declien
• NPH = normal pressure hydrocephalus
• seen in geriatrics
• icp fluctuates
• gait disturbances, incontinence, mental decline, increases viscosity causes problems
• in infanct head is enlarged because skull is able to be moved

• shunts
• external csf drainage
• endoscopic ventriculostomy

• baterial menigitus
• brain abscess: caused by infection somewhere else in the body hat has traveled to the brian, to treat need to know where primary infection is
• viral illness
• aids
• mostly pallative care
• drug resistent bacteria

• posion
• rapid or slw
• pharmacological: overdoes
• baterial toxins: tetanus
• enviormental: metals, chemlical
• after treated for toxin language disorder goes away

• thiamine deficiency
• long term severe alchoholic 
• wernickes korsakoff's
• acute confusion, severe memory loss, confused with AD, tend to confabulate
• B12 deficiency
• over/under of specific vitamins
• food/drug absorbtion

• hypo/hyper glycemia
• thyroid disorder
• wilson's disease: cooper reterntion, genetic, pysch, language and cog problems
• managed with diet

• paresis/paralysis
• recover faster if aarm
• oralfacial deficits
• laryngeal/pharyngeal deficits
• seziures
• grande mal (lost conciousness, body twitch)
• peiete mal: clouded look, still concious
• focal: just one specific area
• jacksonian

• bowel and bladder dysfuntion
• loss of body sensation
• behavioral/pysch aspects
• emotional outbursts, angry, depressed
• visual disturbances: hemianopsia, cortical blindness