PubMed · 9717103
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R Pally. 1998. Bilaterality: hemispheric specialisation and integration.. https://pubmed.ncbi.nlm.nih.gov/9717103/
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Developing guidelines for quality assurance in the management of head injury requires knowledge concerning present management practice. We studied management of minor head injury (MHI) using a cross-sectional mail survey of 76 Swedish hospitals. In 96% of the hospitals, initial patient evaluation, frequently performed by inexperienced physicians, entails neurological assessment according to the Swedish Reaction Level Scale or the Glasgow Coma Scale, while computerised tomography (CT) is used routinely in 4%. This survey indicates great variability in the management of MHI in hospitals in Sweden. Fifteen (21%) hospitals consistently hospitalize all MHI patients for overnight observation, while 56 (79%) have established criteria for early discharge of selected patients. Routines for neurological assessment are satisfactory, while CT scan for skull fracture and early diagnosis of intracranial complications is usually not performed.
The ventromedial temporal area contains numerous anatomical structures collectively or selectively involved in a wide range of neurological and psychiatric disorders. Collective involvement is exemplified best by Alzheimer's disease where a host of anatomical structures and a host of cognitive and behavioral changes are manifested. Selective disease of the amygdala can yield deficits in the ability to judge and evaluate emotional expressions. While memory functions are nearly synonymous with the concept of ventromedial temporal area, they overshadow other functions associated with the diverse anatomical structures in this part of the brain. For example, it could be argued that in addition to output directed toward the hippocampal formation, the output of the ventromedial temporal area is equally strong to the ventral striatopallidal system of the basal forebrain. Denervation of these structures could be associated with the behavioral changes that occur in tandem with the memory-related changes of ventromedial temporal lobe pathology. Here we explore the anatomical and pathological correlate associated with ventromedial temporal area pathology and consider how these may impact on ventral striatopallidal conceptualizations. We conclude that ventromedial temporal area pathology deprives the basal forebrain of multimodal association information from the endstages of corticocortical sensory processing. This endstage information carries with it an analysis of real-time sensory awareness, historical-time or past sensory experiences, and decisions from hippocampal output structures regarding relevancy and novelty. In this sense, basal forebrain structures are in a unique position to regulate behavioral responses to a wide range of stimuli and to organize appropriate emotional, motor, autonomic, and endocrine responses to them.
The formation of the past tense of verbs in English has been the focus of the debate concerning connectionist vs. symbolic accounts of language. Brain-injured patients differ with respect to whether they are more impaired in generating irregular past tenses (TAKE-TOOK) or past tenses for nonce verbs (WUG-WUGGED). Such dissociations have been taken as evidence for distinct "rule" and "associative" memory systems in morphology and against the connectionist approach in which a single system is used for all forms. We describe a simulation model in which these impairments arise from damage to phonological or semantic information, which have different effects on generalization and irregular forms, respectively. The results provide an account of the bases of impairments in verb morphology and show that these impairments can be explained within connectionist models that do not use rules or a separate mechanism for exceptions.