Your brain is the control center of your body. It controls your thoughts, memory, speech, and movement. It regulates the function of many organs. It's part of your nervous system, which also includes your spinal cord and peripheral nerves. The nervous system sends signals between your brain and the rest of the body. Your nerves take in information from your senses and send it to the brain to be processed. Your brain and nerves also communicate to help you move and to control your body's functions.

When the brain is healthy, it works quickly and automatically. But when you have a brain disease, it may affect how well you can function and do your daily activities. Some common brain diseases include:


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The symptoms of brain diseases vary widely, depending on the specific problem. In some cases, damage is permanent. In other cases, treatments such as surgery, medicines, or therapies such as physical, occupational, and speech therapies, may cure the disease or improve the symptoms.

A short overview of the specificities of immune response within the brain is given as an introduction to subsequent chapters on infectious and inflammatory diseases of the child's brain. The blood-brain barrier starts developing during vascular proliferation of the developing brain during neurogenesis but maturation is not completed until several weeks after birth, and varies in different parts of the brain. The development of postcapillary venules in which cell recruitment occurs seems to be completed at birth. Brain macrophages are detected in brain tissue from the 8th to 12th week of gestation and then exert an important role during neuroblast selection and differentiation, as astrocytes and macrophages acquire the ability to secrete soluble substances. From the third trimester, the fetal brain is able to generate an inflammatory reaction and toll-like receptors can be detected on the surface of fetal neurons and glial cells. Innate immunity maturation occurs within weeks after birth. Although neonates lack preexisting immunological memory and have a small number of immune cells in peripheral lymphoid tissues, they are competent to develop a mature T-cell response, they have a strong CD8 cytotoxic function, and dendritic cells are fully competent.

Later the parasites cross the blood-brain barrier into the central nervous system causing the meningo-encephalitic or second stage. Generally this is when more obvious signs and symptoms of HAT appear: behaviour changes, confusion, sensory disturbances and poor coordination. Sleep cycle disturbance, which gives the disease its name, is a prominent feature. Without treatment, HAT is usually fatal although rare cases of self-cure have been reported.

Dr. Joacir Graciolli is a neurological surgeon who specializes in the surgical treatment of brain and spinal disorders of the nervous system. His areas of interest are neurotrauma, chronic pain (including spinal cord stimulation), degenerative spinal disorders, spasticity, epilepsy (VNS) as well as robotic surgery for trigeminal neuralgia. He is also interested in the study of complex multi-modal monitoring, neuroaugmentative and neuroregenerative approaches for the treatment of critically ill patients with traumatic brain injury with the goal of optimizing functional outcome.

Dr. Graciolli is Board Certified in Neurological Surgery from the Brazilian Society of Neurosurgery and by the Landesrztekammer Baden-Wrttemberg (i.e. German Medical Council). After completing his neurosurgical training in Brazil, Dr. Graciolli joined the prestigious department of Stereotactic and Functional Neurosurgery at the German University of Freiburg, a leading center specializing in minimally invasive procedures for movement and psychiatric disorders, chronic pain, epilepsy, and stem cell therapy. At the University of Freiburg, Dr. Graciolli developed innovative techniques for neuromodulation and stem cell therapy for movement disorders and epilepsy while obtaining his PhD.

In the United States, Dr. Graciolli completed a Neurocritical Care fellowship at the Ohio State University. Thereafter, he completed a fellowship in Stereotactic and Functional Neurosurgery as well as Neurotrauma training at the University of Miami with Dr. Jonathan Jagid.

Dr. Graciolli joins the UM Department of Neurosurgery to expand patient care in Neurotrauma and Functional Neurosurgery at the Jackson Health System and Ryder Trauma Center. He is available to see patients at the Jackson North Medical Center, Veterans Affairs Miami, and University of Miami Hospital. He is fluent in English, Spanish, German and Portuguese.

The human brain is the central organ of the human nervous system, and with the spinal cord makes up the central nervous system. The brain consists of the cerebrum, the brainstem and the cerebellum. It controls most of the activities of the body, processing, integrating, and coordinating the information it receives from the sense organs, and making decisions as to the instructions sent to the rest of the body. The brain is contained in, and protected by, the skull bones of the head.

Below and in front of the striatum are a number of basal forebrain structures. These include the nucleus basalis, diagonal band of Broca, substantia innominata, and the medial septal nucleus. These structures are important in producing the neurotransmitter, acetylcholine, which is then distributed widely throughout the brain. The basal forebrain, in particular the nucleus basalis, is considered to be the major cholinergic output of the central nervous system to the striatum and neocortex.[30]

The human brain is primarily composed of neurons, glial cells, neural stem cells, and blood vessels. Types of neuron include interneurons, pyramidal cells including Betz cells, motor neurons (upper and lower motor neurons), and cerebellar Purkinje cells. Betz cells are the largest cells (by size of cell body) in the nervous system.[39] The adult human brain is estimated to contain 868 billion neurons, with a roughly equal number (8510 billion) of non-neuronal cells.[40] Out of these neurons, 16 billion (19%) are located in the cerebral cortex, and 69 billion (80%) are in the cerebellum.[3][40]

The sensory nervous system is involved with the reception and processing of sensory information. This information is received through the cranial nerves, through tracts in the spinal cord, and directly at centres of the brain exposed to the blood.[85] The brain also receives and interprets information from the special senses of vision, smell, hearing, and taste. Mixed motor and sensory signals are also integrated.[85]

Blood pressure and heart rate are influenced by the vasomotor centre of the medulla, which causes arteries and veins to be somewhat constricted at rest. It does this by influencing the sympathetic and parasympathetic nervous systems via the vagus nerve.[93] Information about blood pressure is generated by baroreceptors in aortic bodies in the aortic arch, and passed to the brain along the afferent fibres of the vagus nerve. Information about the pressure changes in the carotid sinus comes from carotid bodies located near the carotid artery and this is passed via a nerve joining with the glossopharyngeal nerve. This information travels up to the solitary nucleus in the medulla. Signals from here influence the vasomotor centre to adjust vein and artery constriction accordingly.[94]

The hypothalamus in the diencephalon, is involved in regulating many functions of the body. Functions include neuroendocrine regulation, regulation of the circadian rhythm, control of the autonomic nervous system, and the regulation of fluid, and food intake. The circadian rhythm is controlled by two main cell groups in the hypothalamus. The anterior hypothalamus includes the suprachiasmatic nucleus and the ventrolateral preoptic nucleus which through gene expression cycles, generates a roughly 24 hour circadian clock. In the circadian day an ultradian rhythm takes control of the sleeping pattern. Sleep is an essential requirement for the body and brain and allows the closing down and resting of the body's systems. There are also findings that suggest that the daily build-up of toxins in the brain are removed during sleep.[96] Whilst awake the brain consumes a fifth of the body's total energy needs. Sleep necessarily reduces this use and gives time for the restoration of energy-giving ATP. The effects of sleep deprivation show the absolute need for sleep.[97]

Neurodegenerative diseases result in progressive damage to different parts of the brain's function, and worsen with age. Common examples include dementia such as Alzheimer's disease, alcoholic dementia or vascular dementia; Parkinson's disease; and other rarer infectious, genetic, or metabolic causes such as Huntington's disease, motor neuron diseases, HIV dementia, syphilis-related dementia and Wilson's disease. Neurodegenerative diseases can affect different parts of the brain, and can affect movement, memory, and cognition.[174]

Most strokes result from loss of blood supply, typically because of an embolus, rupture of a fatty plaque causing thrombus, or narrowing of small arteries. Strokes can also result from bleeding within the brain.[192] Transient ischaemic attacks (TIAs) are strokes in which symptoms resolve within 24 hours.[192] Investigation into the stroke will involve a medical examination (including a neurological examination) and the taking of a medical history, focusing on the duration of the symptoms and risk factors (including high blood pressure, atrial fibrillation, and smoking).[193] Further investigation is needed in younger patients.[194] An ECG and biotelemetry may be conducted to identify atrial fibrillation; an ultrasound can investigate narrowing of the carotid arteries; an echocardiogram can be used to look for clots within the heart, diseases of the heart valves or the presence of a patent foramen ovale.[194] Blood tests are routinely done as part of the workup including diabetes tests and a lipid profile.[194] e24fc04721

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