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Callie Chatterton

Callie Chatterton. Facts. Located directly behind the forehead Most frequently injured Largest portion of the brain 1/3 of cortical area of cerebral hemisphere Connected to many other portions of the brain. Frontal Lobe. Functions. Frontal lobe is critical in executive roles Goal-setting

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Callie Chatterton

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  1. Callie Chatterton

  2. Facts • Located directly behind the forehead • Most frequently injured • Largest portion of the brain • 1/3 of cortical area of cerebral hemisphere • Connected to many other portions of the brain

  3. Frontal Lobe

  4. Functions • Frontal lobe is critical in executive roles • Goal-setting • Completion of purposeful activities • Planning • Also plays important role in social behavior • Inhibition • Judgment/insight • Attention

  5. Phineas Gage • Foreman of a track construction gang • Responsible and well-liked by his crew • Building a railroad through Vermont’s Green Mts. • Frontal lobe damage • 13.25 lb, 3.5 ft. tamping iron penetrates brain • Passes from behind the left eye through the top of the head carrying away a substantial part of the frontal lobe

  6. Phineas Gage

  7. Phineas Gage • No immediate problems after incident • Phineas Gage supposedly never lost consciousness and was up and discussing the accident soon after it happened • Did eventually develop a wound infection but recovered quickly and was soon deemed physically able to return to work • “Gage is no longer Gage” • Before the accident he was responsible, caring, and well-behaved in a social setting. • After the accident he became erratic, profane, and impatient

  8. Causes of Injury • Trauma • Blows from the front, back, or side of the head can result in frontal lobe injury • Even injuries not involving the head can cause bruising of the brain (whiplash) • Diseases • Strokes, lesions, meningitis, tumors

  9. Causes of Injury

  10. Consequences of Injury • Three Frontal Lobe syndromes • Orbitofrontal syndrome (lacks inhibition) • Frontal Convexity syndrome (apathetic) • Medial Frontal syndrome (akinetic) • Answer lab assessments correctly but make poor choices in real situations • Tests of perception, construction, language, and spatial attention are unharmed

  11. Three Syndromes • Orbitalfrontal syndrome • Commonly caused by closed-head injury • Characterized by disinhibited, impulsive behavior, difficulty in controlling their emotions, lacking in judgment and are easily distracted • Many patients are incorrectly diagnosed with a personality disorder • Possible link between violent offenders and traumatic brain injury

  12. Three syndromes • Frontal Convexity syndrome • Characterized by disinterest, slowing of the motor functions and apathy • Inability to regulate behavior according to personal goals • Inability to plan ahead, lack of motivation and concern • Generally not caring about the world around them

  13. Three Syndromes • Medial Frontal syndrome • Characterized by occasional mutism, inability to control sexual appetite and akinesia • Loss of sensation in lower extremities as well as weakness also occur • Many patients experience symptoms from each syndrome

  14. Detection • Unless noticeable damage occurs (car accident trauma, etc.) tests are not usually performed • Normal neurological and psychological tests rarely detect any abnormalities • Requires careful observation of previous and current behavior

  15. Tests • Wisconsin Card Sorting Test • Patient sorts cards into one of four piles based on clues from instructor • Stroop Test • Patients must say the color that the word is written in rather than reading the word itself • Rhythm Tapping Test • Patient essentially imitates rhythm that has been tapped to them (easy to difficult)

  16. Rehabilitation • Goal Neglect • Based on the idea that human behavior is controlled by internal demands in response to the environment • Selection of new actions when previously selected actions fail to achieve the goal • Brief auditory stimuli also used • Drug Therapy • Alter the action of the working memory link and dopaminergic system dysfunction

  17. Rehabilitation • Reinforcement • Simple reinforcement and reward techniques • Organizing the executive system • Targeted to specific areas in which the patient has problems

  18. Conclusion • Rehabilitation is difficult • While there are many similar behaviors, each brain injury is different • Individuals without brain damage • Patients with frontal lobe lesions show similar signs to people without any brain damage (irresponsible, immoral, and flippant)

  19. Resources Burgess, P.W. & I. H. Robertson (2002). Principles of the rehabilitation of frontal lobe function. In D.T. Stuss & R.T. Knight Principles of Frontal Lobe Function (pp. 557-570). Oxford, NY: Oxford University Press. Mesulam, M.-Marsel (2002). The human frontal lobes: Transcending the default mode through contingent encoding. In D.T. Stuss & R.T. Knight Principles of Frontal Lobe Function (pp. 8-28). Oxford, NY: Oxford University Press. Tranel, D. (2002). Emotion, decision making, and the ventromedial prefrontal cortex. In D.T. Stuss & R.T. Knight Principles of Frontal Lobe Function (pp. 338-353). Oxford, NY: Oxford University Press.

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