This document provides information about brain injury, including causes such as trauma, infection, lack of oxygen, and poisons like alcohol. It discusses the basic anatomy of the brain and structures commonly affected by different types of injuries. Specific syndromes are examined, such as frontal syndrome from traumatic brain injury and Korsakoff's syndrome from alcoholism, including associated behaviors. Case studies are presented to illustrate some of these conditions. The conclusion emphasizes the challenges of differentiating brain damage from psychosis but notes understanding the injury can help manage behaviors.

1. What is Brain Injury?
Brain Injury or Behaving Badly?
Stephen Wilson
North Shore Ryde Health Service
Mater Hospital
30 April 2013

2. Program
• The nerve cell
• Basic Brain Anatomy
• What are the syndromes and behaviours
associated with Brain injury
[TBI/Alcohol/Hypoxia]

3. The Fragile Nerve Cell
• Oxygen
• Glucose
• Thiamine
• Oxygen
• Glucose
• Thiamine(B1)
• Neuro transmitters
• Protection: Bone, Blood
brain barrier
• Support: CSF, Glial Cells
• Nourishment: Diet
• Growth: Neuroplasticity

4. Brain Injury
Neurone damage Causes
• Trauma
• From Birth
Intellectual disability
• Infection/Encephalitis
HIV dementia, Tertiary
Syphilis, CJD, Herpes simplex
• Lack of oxygen
Associated with drug
overdose, suicide, cardiac
arrythmia, stroke
• Poisons
Alcohol, Methyl
alcohol, Marijuana

5. Brain Anatomy

6. Traumatic Brain Injury
Frontal Syndrome
Structures

7. Traumatic Brain Injury
Frontal /Executive Function
Behaviour
• Inability making decisions
• Motivation
• Inappropriate behaviour
• Controlling emotions
• Social behaviour
• Lack of Self-awareness
• Neglect appearance
Executive
• Planning and organisation
• Flexible thinking
• Monitoring performance
• Multi-tasking
• Solving unusual problems
• Learning rules
• Concentrating and taking in
information
• Delayed cognitive
processing

8. Case Study

9. Alcohol
Structures
Cerebellum
Limbic system
Hippocampus
Peripheral nerves/sensation
Optic nerves (metho)

10. Alcohol
Korsakoff’s Syndrome
Symptoms
• Poor balance, Ataxia
• Numb feet
• Retrograde Amnesia
• Antero grade amnesia
• Heavy alcohol consumption
• Poor diet and thiamine
deficiency
Behaviour
• Confabulation: invents
events to fill the gaps in
memory
• difficulty in acquiring new
information or learning new
skills
• Poor insight: believe that
their memory is functioning
normally
• Talkative repetitive

11. Case Study
• Dory: I don't know where I
am... I don't know what's
going on. I think I lost
somebody but I, I can't
remember... and I can't
remember...
• I suffer from short-term
memory loss. It runs in my
family... At least I think it
does... hm. Where *are*
they?

12. Hypoxia
Structures
• Diffuse brain damage
• Boundary zone/Watershed
• Basal ganglia
Behaviour
• Movement disorders
• Gait Parkinsonism
• Epilepsy
• Cognitive impairment
• Agnosia
• Features of Korsakoff and
TBI

13. Case Study

14. Conclusion
• Difficult to decide Psychosis vs Brain damage
• May be co existent
• Understanding the injury may help with
managing behaviour

15. Questions?