NeuronalRecovery - • Follows myelin sheaths when possible...

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1 Recovery from nerve damage Stroke Hemorrhagic (hemolytic) Aneurysm Thrombotic (ischemic) Blood clot, atherosclerosis Trauma Closed head injury Acute Chronic Tumors Damage from stroke Cell damage – Overstimulation release of K+, glutamic acid lack of homeostasis in cellular metabolism – Understimulation • apoptosis diaschisis (downstream understimulation) Damage from trauma Closed head injury – Acute Subdural hematoma; other bleeding Contra cu injuries – Chronic Dementia pugilistica Other dementias
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2 Recovery • Age – Kennard principle Young is better (often in error, however) Physical therapy – Usually helpful • Reorganization – Many components Reorganization of the nervous system Regrowth of axons – Sperry: growth along/toward chemical signals – Weiss: axoplasmic transport, growth
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Unformatted text preview: • Follows myelin sheaths when possible – Better in PNS; usually fails in CNS • Poor guidance; often fails • Glial scars Sprouting of axons • Usually occurs spontaneously • Merzenich experiment • Similar to development – Probably selective apoptosis • Results in humans – Not always correctly rewired 3 Other neat facts: • Denervation supersensitivity – Surely part of the regrowth/sprouting phenomenon • Effect of catecholaminergic agonists – Amphetamine, other DA agonists – Better when combined with PT • Effect of antagonists – Haldol inhibits Conclusions • Things are not easy – other tissues, cells heal much better • Field has carefully optimistic view – Better drugs – other methods...
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