Disorders of Brain Function

Disorders of Brain Function

Disorders of Brain Function

Bonnie is a 70-year-old woman who lives alone. One evening, she felt light-headed and dizzy. When her head began to ache, she decided to take an analgesic and go to bed early. The following morning, upon awakening, she was unable to move the bed sheets with her right arm. At this point she was experiencing tingling sensations in her limbs, and she had difficulty keeping her balance. She dialed 911 for help, and by the time the ambulance arrived, she was confused and unable to articulate her words although she knew what information he was asking of her. In the hospital, she was examined and treated for ischemic stroke.

  1. Stroke, or brain attack, involves brain tissue injury. Describe ischemic penumbra and what factors contribute to the survival of the neurons involved. What happens if the cells of the penumbra are unable to be preserved?
  2. Compare and contrast hypoxia and ischemia. What condition is more dangerous to the brain? Explain your answer.
  3. Knowing what you do about the effects of ischemia on the brain, why would someone with ischemic stroke develop cerebral edema?
  4. What type of aphasia was Bonnie exhibiting when talking to her caregivers? Explain your answer.



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Disorders of Brain Function

In a globe where the enigma of the mind progresses to be largely uncharted, the disorder of the brain function stands as a perplexing poser, captivating scientists, and compelling society to untangle their complexities. The affliction of brain function comprises a vast range of conditions affecting the brain’s normal functioning, resulting in severe disruptions in cognitive, emotional, and behavioural procedures. These infirmities can evolve from numerous causes involving genetic predisposition, neurological malformations, trauma, and environmental factors. Examples of such infirmities are schizophrenia, bipolar infirmity, attention-deficit or hyperactivity disease, and Alzheimer’s disorders, among others (Xu et al. 2). Each infirmity presents distinctive manifestations and difficulties, making diagnosis and treatment challenging. While our comprehension of these infirmities has advanced crucially, there is still much to learn about the underlying procedure and successful interventions. With further research and development in neuroscience, we are believed to improve our ability to diagnose, treat, and eventually prevent these infirmities, offering individuals affected by the disorders a better quality of life. This paper will explore a case scenario of Bonnie, a 70-year-old woman living alone when one evening, she felt light-headed and dizzy, eventually describing ischemic penumbra and the factors contributing to the survival of neurons involved, what happens when the cells of the penumbra are unable to be preserved, comparing hypoxia and ischemia and the condition that is more dangerous to the brain, explaining why someone with ischemic stroke develops cerebral edema, and the type of aphasia that Binnie exhibited when taking to caregivers.

The Ischemic Penumbra and Factors Contributing to the Survival of the Neurons Involved

Numerous factors, including collateral circulation, metabolic demands, the timing of reperfusion, and personal neuronal tolerance, impact neurons’ survival within the ischemic penumbrae. Ischemic penumbra is a region of the brain surrounding the core of an ischemic stroke, where blood flow is significantly lessened but not entirely blocked (Leigh et al. 1506). This area represents an essential zone with compromised perfusion, and its fate decides the result of the stroke. The survival of neurons within the ischemic penumbra varies on various factors. Collateral blood flow plays a crucial role because it equips an alternative source of blood to the impacted area. The extent and effectiveness of collateral circulation decide the degree of oxygen and nutrient transfer to the neurons. Metabolic insistence of the penumbra is essential; as lower desire can sustain the neurons for longer durations. Time is a vital factor, as the period of ischemia directly influences the survival of neurons. Timely reperfusion through medical interventions, like thrombolysis or mechanical clot retrieval, can reclaim the penumbra, elevating the chances of neurons survival (Campbell et al. 18). In addition, individual variations in the tolerance of neurons to ischemia impact the ability to withstand the oxygen and nutrient deprivation. Hence, optimizing collateral circulation, lessening metabolic desires, abrupt reperfusion, and comprehending personal neuronal tolerance are all crucial factors in fostering the survival of neurons in the ischemic penumbra.

The Upshots of Failing to Preserve Cells in the Penumbra

If the penumbra’s cells cannot be preserved, it can lead to significant consequences in the context of brain health. The penumbra refers to the area surrounding the core of a stroke or other forms of brain injury, where cells are still viable but at risk of irreversible damage (Horváth et al. 36). These cells are compromised due to reduced blood flow and oxygen supply. If the penumbra cells cannot be preserved, they will eventually succumb to the ongoing injury process, leading to their death or dysfunction. This can lead to the expansion of the core injury and the exacerbation of neurological deficits. The loss of penumbra cells can subscribe to the severity of neurological impairments, like motor, sensory, or cognitive deficits, varying on the specific brain region impacted (Andrzejewska et al. 16). Preserving and salvaging the penumbra cells is essential for lessening the long-term consequences of brain injuries and enhancing the chances of functional recovery.

Comparing and Contrasting Hypoxia and Ischemia, and the Dangerous State of the Brain

Hypoxia and ischemia are conditions involving a lack of oxygen supply to the brain, but they differ in their underlying procedures. Hypoxia is a lessened level of oxygen in the blood due to numerous motives like high altitude, respiratory infirmities, or cardiac arrest (Zubieta-Calleja and Natalia 2). Ischemia, conversely, is distinguished by a limitation or obstruction of blood flow to the brain, frequently caused by blood clots or atherosclerosis in the cerebral blood vessels. While both statuses can harm the brain, ischemia is considered more dangerous. In ischemia, the blood provision to a particular brain region is discontinued, resulting in a rapid dwindling of oxygen and nutrient suitable for a proper brain operation. This can lead to the death of brain cells within piffling, causing an ischemic stroke or transient ischemic attack, with ischemic strokes being the leading cause of impairment and can lead to long-term neurologic shortfalls or even death if not treated on time.  Hypoxia, although severe, customarily impacts the entire brain rather than the specific regions (Zhang et al. 19). It can occur because of respiratory or cardiac failure, profound blood loss, or carbon monoxide poisoning. Severe hypoxia can result in irreversible brain harm, but it may take longer for the impacts to manifest compared to ischemia. Both hypoxia and ischemia entail a lack of oxygen supply to the brain, but ischemia, with its instantaneous and localized influence, is generally considered more harmful because of its possibility to cause severe brain cell death and lasting neurological outcomes rapidly.

Reasons why Someone with ischemic Stroke Develop Cerebral Edema

Ischemic stroke happens when the blood provision to a brain region is impeded, resulting in insufficient oxygen and nutrient delivery to the impacted part. This lack of blood flow leads to ischemia, which stimulates a cascade of events, leading to cerebral edema (Xu et al. 8). Ischemia causes cellular energy exhaustion and the discharge of provocative mediators, resulting in an inflammatory response in the brain. This soreness interferes with the blood-brain barrier, a protective obstruction that manages the movement of substances between the blood and brain tissue. As an outcome, fluid and proteins leak from the blood vessels into the brain tissue, resulting in cerebral edema. In addition, the ischemic brain tissue swells due to sodium and water accumulation, further subscribing to edema. Cerebral edema can be a severe complication of ischemic stroke as it elevates intracranial pressure and further compromises blood flow, potentially worsening harm to the brain.

The Type of Aphasia that Bonnie Exhibits when Talking to her Caregivers

Based on the information, Bonnie exhibited expressive aphasia when talking to her caregivers. Expressive aphasia, also known as Broca’s aphasia, is a type of communication infirmity caused by damage to the brain’s frontal lobe, consistently in the left hemisphere (Lau et al. 125). It impacts an individual’s ability to articulate and produce speech fluently. In Bonnie’s case, her inability to articulate her words despite knowing the information being asked of her suggests a difficulty in verbal expression. This is further supported by her confusion and the tingling sensations she experienced, commonly associated with ischemic strokes that affect the brain’s language centers. Bonnie’s symptoms indicate that the stroke has impaired the coordination between her thoughts and the motor movements required for speech production, leading to expressive aphasia.


Disorders of brain function can have severe results on an individual’s life, as illustrated by Bonnie’s encounter with an ischemic stroke. The case study highlights the significance of comprehending conditions like an ischemic penumbra, which refers to the area of the brain surrounding the core of the stroke where brain cells are at risk but not yet irreversibly damaged. Factors subscribing to the survival of neurons in the penumbra include collateral circulation, metabolic demand, and timely intervention. Moreover, irreversible damage and functional impairment can occur if the penumbra’s cells cannot be preserved. In addition, the comparison between hypoxia and ischemia discloses that ischemia, which involves insufficient blood flow and oxygen provision to the brain, is more harmful due to the rapid expenditure of energy reserves and subsequent cellular dysfunction. Necessarily, the establishment of cerebral edema is a joint event in ischemic stroke resulting from disrupted blood-brain barrier function and fluid accumulation. Finally, Bonnie’s difficulty articulating words while retaining comprehension indicates expressive aphasia, specifically Broca’s aphasia, which is associated with damage to the frontal lobe. These examples underscore the intricate relationship between brain disorders, their effects on neural structures, and subsequent functional impairments.

Work Cited

Andrzejewska, Anna, et al. “Mesenchymal Stem Cells for Neurological Disorders.” Advanced Science, vol. 8, no. 7, 2021, p. 2002944, https://doi.org/10.1002/advs.202002944. Accessed 5 Jun. 2023. https://doi.org/10.1002/advs.202002944

Campbell, Bruce CV, et al. “Ischaemic stroke.” Nature Reviews Disease Primers 5.1 (2019): 70. https://doi.org/10.1038/s41572-019-0118-8

Horváth, Emőke, et al. “Ischemic damage and early inflammatory infiltration are different in the core and penumbra lesions of rat brain after transient focal cerebral ischemia.” Journal of Neuroimmunology 324 (2018): 35-42. https://doi.org/10.1016/j.jneuroim.2018.08.002

Lau, Yoke Lian, Chek Kim Loi, and Mohd Nor Azan bin Abdullah. “THE HISTORICAL DEVELOPMENT OF THE STUDY OF BROCA’S APHASIA.” MNJ (Malang Neurology Journal) 7.2 (2021): 125-128. http://orcid.org/0000-0002-7949-7683

Leigh, Richard, et al. “Imaging the physiological evolution of the ischemic penumbra in acute ischemic stroke.” Journal of Cerebral Blood Flow & Metabolism 38.9 (2018): 1500-1516.

Xu, Feiyu, et al. “Segmental abnormalities of superior longitudinal fasciculus microstructure in patients with schizophrenia, bipolar disorder, and attention-deficit/hyperactivity disorder: An automated fiber quantification tractography study.” Frontiers in Psychiatry 13 (2022).

Xu, Qingxue, et al. “Relevant mediators involved in and therapies targeting the inflammatory response induced by activation of the NLRP3 inflammasome in ischemic stroke.” Journal of Neuroinflammation 18.1 (2021): 1-23. https://doi.org/10.1186/s12974-021-02137-8

Zhang, Jing-Jing, et al. “Early predictors of brain injury in patients with acute carbon monoxide poisoning and the neuroprotection of mild hypothermia.” The American Journal of Emergency Medicine 61 (2022): 18-28. https://doi.org/10.1016/j.ajem.2022.08.016

Zubieta-Calleja, Gustavo, and Natalia Zubieta-DeUrioste. “The oxygen transport triad in high-altitude pulmonary edema: a perspective from the high Andes.” International Journal of Environmental Research and Public Health 18.14 (2021): 7619.  https://doi.org/10.3390/ijerph18147619

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