It's All in Your Head! Trivia Quiz

Answer: subdural hematoma

Subdural hematoma is a blood clot located under the protective structure called the dura mater. Clinically, it looks like a brain tumor or acute stroke with focal paralysis, confusion, and sometimes coma. CAT scan shows the difference.
Multiple sclerosis starts with physical symptoms that appear and disappear unpredictably. If the brain's mood-regulating centers are affected, the patient may also have mania, depression, or unpredictable rage. MRI shows one or more areas of brain involvement and is the diagnostic test needed.
Frontal lobe tumors disturb the patient's judgment and impulse control, resulting in behavioral changes. These get worse over time. MRI scan will show the tumor responsible.
Lupus causes inflammation of body structures, including the skin, kidneys, and brain. Blood tests show antibodies that attack the involved tissues. When these antibodies attack the brain, they can cause insomnia, somnolence, mood swings and sometimes delirium.
These diseases are still misdiagnosed in 2003, because many patients (and family doctors!) assume that mood, thought, and behavior changes are always due to stress or to primary psychiatric disorders. Tragically, this belief can result in missed opportunities for early diagnosis and treatment.

Answer: False

Confusion and trouble remembering recent and current events are often the first signs noticed. The others start to develop later in the course of the disease. Medications are available to slow the progression of Alzheimer's.

Answer: Creutzfeld-Jakob disease

Creutzfeld-Jakob disease (human spongiform encephalopathy) can be caused by exposure to infectious tissue from others. Patients have developed it after treatment with pituitary hormones, and after corneal transplants. One type is caused by eating infected meat ("mad cow disease"). Most often, a mutation in brain proteins occurs spontaneously.

The tissue will then be infectious to others, but the disease cannot be transmitted by ordinary contact. No treatment is known at this time. Pituitary hormone replacement now uses synthetic human hormones. Corneas are not accepted from donors who die with signs of this disease.

Answer: True

Small blood vessels in the brain may leak under the excessive pressure, causing "ministrokes" which result in memory and thinking problems. Controlling the blood pressure can slow the progress of this condition.

Answer: False

A technique called SPECT scanning is described here. It's not used in clinical practice as of 2003. PET scans measure the rate at which brain cells use blood glucose; the harder they work, the more energy they need! PET scanning is used currently as a clinical tool. Both of the radioactive isotopes rapidly decay without generating dangerous high-frequency radiation.

Answer: blindness

Deafness can be caused either by damage to the sensors in the ear itself or by auditory nerve damage interrupting the transmission of the sensory information. Loss of language perception is called Wernicke's aphasia. Its cause is damage to the left temporal area. Staggering can be caused by damage to the cerebellum, the motor nerve tracts, or the inner ear. None of the above structures would be endangered by a blow to the back of the head. The area responsible for interpreting visual information is located at the back of the brain, however, and is vulnerable to damage from a blow to the back of the head.

Interestingly, a person with this type of blindness may be unaware of it as the damaged sensory area is not able to detect the absence of visual information.

Answer: Daily maternal consumption of 100-200 milligrams of caffeine while pregnant.

The commonest genetic cause is trisomy 21, or Down's syndrome. Meningitis and encephalitis can be viral or bacterial. Many types can be prevented by use of available vaccines. No researchers have performed controlled prospective studies of caffeine intake during pregnancy, for ethical reasons.

However, some proposed sources of problems have been measured in non pregnant women. These proposed risk factors include continuous high levels of catecholamines (naturally produced stimulating hormones which might have an impact on brain development) and continuously elevated blood pressure. Neither of these conditions has been found to occur in test subjects consuming moderate amounts of caffeine (100-300 milligrams) on a daily basis.

Many obstetricians recommend eliminating caffeine anyway, since it plays no known essential role in nutrition.

Answer: True

The Parkinsonism developed by many boxers is believed to result from repeated blows to the head. Exposure to carbon monoxide is associated with later development of Parkinsonism.
Medications that have Parkinsonian side effects include most antipsychotics, Compazine, and Reglan. Stopping the medication solves this problem.
Patients who recovered from the 1918 influenza strain sometimes developed severe Parkinsonism later. Fortunately, no more flu epidemics have had similar complications as of 2003.
Family members of Parkinson's patients sometimes appear to have a higher risk of developing it themselves. The reason for this is not known.
The commonest cause of Parkinsonism is true Parkinson's disease. This appears spontaneously and has no known cause.

Answer: Substantia nigra.

Anatomists working in Renaissance times lacked microscopes, so many of the names they assigned were simple descriptions.

Answer: True

This finding may be useful in the future for prognosis and treatment decisions.