Brain Crack Level 37

[Vita Wanberg]

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Brain-tissue shifts associated with drowsiness, stupor, and coma were studied by clinical examination and CT scanning in 24 patients with acute unilateral cerebral masses. Studies were performed soon after the appearance of the mass to detect the earliest CT changes associated with depression of consciousness. Contrary to traditional concepts, early depression of the level of alertness corresponded to distortion of the brain by horizontal displacement rather than transtentorial herniation with brain-stem compression. Horizontal displacement of the pineal body of 0 to 3 mm from the midline was associated with alertness, 3 to 4 mm with drowsiness, 6 to 8.5 mm with stupor, and 8 to 13 mm with coma. Moreover, drowsy or stuporous patients and some comatose patients had widened cisterns between the tentorial edge and the midbrain on the side of the mass, suggesting that the space was not filled by herniated medial temporal lobe. Downward displacement of the pineal body, indicating central transtentorial herniation, did not occur. Compression of one hemisphere by the other anteriorly (transfalcial herniation) was inconsistently related to alertness, though very large anterior displacements may have caused stupor in some patients. Current concepts of the pathoanatomical nature of depressed consciousness, based on pathological material obtained well after clinical examinations, may require revision, because they do not reflect early brain-tissue distortions.

The healthy human brain contains tens of billions of neurons, which are specialized cells that process and transmit information via electrical and chemical signals. These cells send messages between different parts of the brain, and from the brain to the muscles and organs of the body. Alzheimer's disease disrupts this communication, resulting in widespread loss of brain function as many neurons stop working properly and eventually die.

Microglia protect neurons from physical and chemical damage and are responsible for clearing foreign substances and cellular debris from the brain. Astrocytes are star-shaped glial cells with important metabolic, structural, regulatory, and protective functions. Oligodendrocytes form the myelin sheath, the protective and supportive cellular insulation around axons, which are long, slender cells that send electrical signals to other parts of the body.

To carry out these roles, glial cells interact with blood vessels in the brain. Microglial cells and astrocytes are also involved in immune response in the brain. Together, glial and blood vessel cells regulate the delicate balance within the brain to ensure that it functions at its best. In recent years, an increasing amount of scientific evidence has suggested that activation of microglial and astroglia cells might play a role in brain inflammation.

Figure 1. Screenshots from the experimental paradigm. Top: a scene from the construction condition with two lanes of reduced width. Bottom: a scene from the non-construction condition with three lanes and normal lane width.

Figure 4. Prediction accuracies of driving difficulty for the models separate for each WML level. Individual accuracy score is indicated as dots. Mean accuracy per WML level and its standard error of the mean are depicted in purple. Dashed line at 50% indicates the theoretical guessing level.

Figure 5. Classifier output predicting driving difficulty for example participants P7 and P14. Colors indicate the actual driving condition and vertical dashed lines indicate the class limit of the logistic regression output. Values larger than 0.5 were assigned to the construction condition. (A) For the separate prediction models, most signal samples are predicted correctly at intermediate WML levels (1-back to 3-back level). (B) For the combined model, many signal samples are incorrectly classified.

Copyright 2019 Scheunemann, Unni, Ihme, Jipp and Rieger. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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