Cerebral hemorrhage (apoplexy)

Etiology. Cerebral hemorrhage is most likely to occur in persons who have hypertension and arteriosclerosis. In fact, it is one of the serious complications of hypertension. Most cases occur after the age of fifty.

Symptoms and signs. The onset is usually sudden with the development of severe headache, paralysis or unconsciousness within a few minutes. Some cases, however, are marked by a more gradual development during which period the patient complains of dizziness, visual disturbances, headache and perhaps mental aberrations.

For some unexplained reasons the branches of the sylvian arteries — those which supply the motor area of the brain — are the ones most commonly affected and consequently paralyses are commonly observed.

In the more serious cases unconsciousness occurs within a relatively short period after the onset, and by the time the physician is called the patient is in a deep stupor. A variety of neurological signs may be evident, depending of course upon the location of the hemorrhage. There is often a deviation of the eyes which usually "look toward the affected side." The pupils are fixed; there may be evident paralysis of the facial muscles on the affected side.

During the early stages the limbs may be flaccid, but, later, evidence of upper motor neuron involvement becomes evident with the increasing muscle tone, hyperactive reflexes and presence of pathologic reflexes (Babinsky, Hoffman, and others). Ankle clonus may be evident. Hemorrhage into parts of the brain other than the motor area may produce a diversity of symptoms and findings.

Diagnosis. In severe cases there is usually little difficulty with the diagnosis — the presence of hypertension, the suddenness of the onset, the development of paralysis being found in combination. Examination of the spinal fluid reveals an increase of the pressure and in most instances there will be gross blood.

Prognosis. The prognosis of cerebral hemorrhage is grave. It is poorest in those cases in which profound coma persists for twenty-four hours or longer and in those patients who develop a high fever. If consciousness returns, the patient stands a good chance of recovery, but may suffer from subsequent attacks at any time. Paralyses often improve after one or two weeks as the edema of the brain subsides. Paralyses lasting two weeks or longer are likely to be more or less permanent.

Treatment. The treatment of cerebral hemorrhage is largely supportive. Close nursing attention to prevent strangulation and aspiration is important. In those cases in which the patient recovers from the initial acute symptoms, every effort should be directed toward the maintenance of muscle function by massage and passive exercise.

POST-TEXT ASSIGNMENTS

Exercise 7. Answer the questions:

What are the causes of apoplexy?

At what age is apoplexy likely to occur?

Is the onset of the disease sudden or gradual?

Why is paralysis most commonly observed?

What eye signs are evident in cerebral hemorrhage?

What is the prognosis of the disease?

What does treatment consist of?

Exercise 8. Find synonyms to the following words in the text:

Bleeding, giddiness, case, investigation, extremities, constant, data, convalescence, elevation, deep

Exercise 9. Find English equivalents to the following word combinations:

Серьезное осложнение, постепенное развитие, зрительные расстройства, мышечный тонус, пораженная сторона, локализация кровоизлияния, лицевые мышцы, относительно короткий период, вовлечение верхнего моторного нейрона, сверхактивные рефлексы, спинномозговая жидкость, первоначальные острые симптомы, глубокая кома, массивное кровотечение, последующие приступы, внезапность начала.

Exercise 10.Insert prepositions:

There may be evident paralysis … the facial muscles … affected area.

In serious cases unconsciousness occurs … a relatively short period.

… the early stages the limbs may be flaccid.

The prognosis is poor …cases when profound coma persists … twenty-four hours or longer.

Some cases of apoplexy are marked … a more gradual development.

Neurological signs may depend … the location … hemorrhage.

… severe cases there is usually little difficulty … the diagnosis.

Exercise 11. Translate the sentences with the Complex subject (revision)

1. After vitamin injections some patients seem to have improved.

2. He was known to have had a hernia for many years.

3. Precise monitoring of serum electrolytes would appear essential before and during antiarrhythmic drug therapy.

4. Coronary patients have now been established to be at increased risk of cardiac mortality.

5. Injuries are most likely to have occurred in children.

6. The number of drugs are known to have been available for the treatment of cardiac failures.

7. The cell happened to have divided during the experiment.

Exercise 12. Translate the following sentences using the Complex subject:

1. Лимфоциты, как известно, регулируют иммунный ответ.

2. Ферменты, по-видимому, очень лабильны.

3. Очевидно, онкологи научатся лечить рак.

4. Сообщили, что ученые Канады изолировали ген, определяющий пол ребенка.

5. Обнаружили, что это явление имеет широкое распространение.

6. Известно, что гипертония и ишемическая болезнь сердца составляют большой процент заболеваемости.

7. Сообщалось, что операции по вживлению искусственного сердца человеку проводятся в США и в нашей стране.

8. Известно, что операции по вживлению искусственного сердца сложны и многоплановы.

9. Известно, что созданы портативные дефибрилляторы.

10. Результаты оказались удовлетворительными.

Exercise 13. What do you mean by

spinal fluid

headache

paralysis

Exercise 14.SYMPTOMS.Choose the correct answers.

1. She has been working so hard she feels quite ... .

a) careful b) dull c) exhausted d) wasted

2. The dog was in a terrible ... when we found it.

a) condition b) danger c) illness d) sickness

3. His illness made him ... of concentration.

a) incapable b) incompetent c) powerless d) unable

4. I felt a sharp ... when I put my hand in the boiling water.

a) ache b) harm c) pain d) suffer

5. If you have got measles, your body is covered in ... .

a) blots b) dots c) freckles d) spots

6. There is a small hard ... on my wrist. I think I'd better see the doctor.

a) bruise b) lump c) rash d) swelling

7. I have a bad cold, and have lost all ... of smell.

a) degree b) scent c) sense d) skill

8 He ... from rheumatism.

a) hurts b) pains c) suffers d) troubles

9. Women seem able to ... pain better than men.

a) bear b) carry c) support d) wear

10. I couldn't go to the party because of a ... cold.

a) fast b) hurried c) sudden d) surprising

11.I have a ... headache.

a) burning b) raving c) spitting d) splitting

12. Her sister's ... kept me awake for half the night.

a) blowing b) coughing c) flowing d) swallowing

13. His stomach began to ... because of the bad food he had eaten.

a) ache b) be hurt c) harm d) pain

14. You can die from breathing the ... from a car engine for too long.

a) air b) fumes c) smoke d) steam

15. He says he has got … in his stomach.

a) aches b) hurt c) pains d) suffering.

TEST

1. Insult is one of the serious complications of... .

a) hypotension

b) neuritis

c) hypertension

d) angina pectoris

e) myocardial infarction

2. Most cases of apoplexy occur after the age of... .

a) 30

b) 40

c) 50

d) 60

e) 70

3. The onset of apoplexy is usually... .

a) gradual

b) abrupt

c) sharp

d) sudden

e) slow

4. Apoplexy is most commonly accomponied by ... .

a) vomiting

b) paralysis

c) nausea

d) diarrhea

e) constipation

5. The prognosis is poorest in those patients who develop... .

a) severe cough

b) rales

c) breathlessness

d) pain

e) a high fever

6. Paralyses often improve after... as the edema of the brain subsided.

a) one or two days

b) one or two weeks

c) several days

d) a month

e) several months

7. Examination of the spinal fluid reveals an increase of the... .

a) leucocyte count

b) meningococci

c) pressure

d)erythrocyte count

e) neutrophils

8. Paralyses lasting ... or longer are likely to be more or less permanent.

a) one or two days

b) three-four days

c) a week

d) two weeks

e) a month

9. A vaiety of neurological signs may be evident depending... the location of the hemorrage.

a) in

b) upon

c) at

d) from

e) by

10. If consciousness returns, the patient may suffer... subsequent attacks at any time.

a) on

b) at

c) from

d) for

e) in

E P I L E P S Y

Exercise 1. Practice the pronunciation:

Neuron ['njuәron], Wiring ['waiәriŋ], Outwardly ['autwәdli], Embarrassment [im' bærәsmәnt], License ['laisәns], Threatening ['qretniŋ], Enhance [in' ha:ns],

Goal [goul], Transplanting [træns'pla:ntiŋ]

Exercise 2. Topic vocabulary:

Cluster скопление

Wiring фиксация

Seizure эпилептический припадок

To interfere вредить

Outwardly внешне, снаружи, на вид

Embarrassment затруднение, препятствие, расстройство,

нарушение, недостаточность

Social setting окружение

Recreational развлекательный

To enhance усилить

To predict предсказывать

Exercise 3. Match English word combinations with the following Russian ones:

1. Clusters of nerve cells   2. Loss of consciousness 3. To lead to seizures 4. Diagnostic test for epilepsy   5. Brain scan 6. Vagus nerve stimuli   7. Behavioral and emotional problems   8. refuse drivers licenses 9. Life-threatening 10. Sudden unexplained death   11. With goal to enhancing treatment   12. Transplanting fetal pig neurons 13. to maintain a strict diet 14. rich in fats and low in carbohydrates food

1. пересадка эмбриональных нервных клеток свиньи; 2. внезапная необъяснимая смерть; 3. раздражители блуждающего нерва; 4. диагностический тест на эпилепсию; 5. скопление нервных клеток; 6. отказ на получение водительских прав; 7. вести к эпилептическим припадкам; 8. потеря сознания; 9. опасный для жизни; 10. богатая на жиры и бедная на углеводы пища; 11. поведенческие и эмоциональные проблемы; 12. с целью усиления лечения; 13. поддерживать строгую диету 14. сканограмма мозга

Exercise 4. Match medical terms with the proper definitions:

1. ketogenic diet   2. Synapse   3. Neurons     4. Neurotransmitter     5. gamma-aminobutryic acid   6. Vagus nerve     7. Epilepsy

1. – a disorder of the brain function characterized by recurrent seizures that have a sudden onset. 2. – (nerve cell) one of the basic functional units of the nervous system: a cell specialized to transmit electrical nerve impulses and so carry information from one part of the body to another. 3. – a chemical substances released from nerve endings to transmit impulses across synapses to other nerves and across the minute gaps between the nerves and the muscles or glands that they supply. 4. – the minute gap across which the nerve impulses pass from one neuron to the next, at the end of a nerve fiber. 5. – the tenth cranial nerve , which supplies motor nerve fibers to the muscles of swallowing and parasymphatic fibers to the heart and organs of the chest cavity and abdomen. 6. – an amino acid found in the central nervous system, predominantly in the brain, where it acts as an inhibitory neurotransmitter. 7.– a diet that promotes the formation of ketonic bodies (are produced during the metabolism of fats) in the tissue.

Exercise 5. Give the adjectives and adverbs in the comparative and superlative degree. Find in the text such adjectives or adverbs.

Model 1: great – greater – the greatest

Thick, large, near, thin, late, early, highly, narrow, few, busy.

Model 2: difficult – more difficult – the most difficult

Interesting, important, different, careful, virulent, easily, slowly

Model 3: good/well – better – the best

Bad, much/many, little, old, badly, far.

Exercise 6: Form adjectives from the given words with the help of the given suffixes. Translate them into Russian.

- ful care, pain, beauty, use, harm, hope

- less use, hope, sleep, rest, pain, home, life

- al nature, practice, experiment, mechanic

- y wind, bone, salt, health, ease, sleep, rapid

- able change, move, eat, response, consider

- ous infection, danger, nerve, fiber, vein

- ive ( - tive, -ative) express, connect, cause, operate

- ic history, metal, psyche, system, science

Exercise 7.Translate into Russian. Pay attention to the sentences with Infinitive.

The patient to be operated on was brought to the hospital on a stretcher.

This is the patient to be given general anesthesia.

The surgeon took a scalpel to make a midline abdominal incision.

The surgeon must be operating on the patient with a perforative appendicitis now.

To prevent complications after the flu one must go to bed at the onset of the disease and take prescribed drugs.

To treat advanced cases of malignant tumors is very difficult.

We had to take the newly admitted patient for an operation immediately to prevent the rupture of the appendix.

The old man was too weak to be operated on and the doctor decided to postpone the operation.

Exercise 8. Open the brackets using Infinitive in the appropriate form:

This is the patient (to take) to ward.

He wanted (to send) to the oncological centre for practice.

He seems (to recover) by and by (gradually).

The students were glad (to show) a plastic operation yesterday.

(To operate) on this patient we must give him a local anesthesia first.

The nurse brought the blood (transfer) to the patient (to operate).

The stitches are (to remove) on the tenth post-operative day.

(To consider) negative, an infant must have a negative DNA after age one month.

The patient had (to take) to an operation immediately to prevent the rupture of the appendix.

Further studies are needed (to characterize) the cause and possible treatment of hyper ammonia after lung transplantation.

Exercise 9. Read and translate the text:

EPILEPSY.

Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness. Epilepsy is a disorder with many possible causes. Anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development - can lead to seizures. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, or some combination of these factors. Having a seizure does not necessarily mean that a person has epilepsy. Only when a person has had two or more seizures is he or she considered to have epilepsy. *EEGs and brain scans are common diagnostic test for epilepsy.

Once epilepsy is diagnosed, it is important to begin treatment as soon as possible. For about 80 percent of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques. Some antiepileptic drugs can interfere with the effectiveness of oral contraceptives. In 1997, the FDA approved the vagus nerve stimulator for use in people with seizures that are not well-controlled by medication.

Scientists are studying potential antiepileptic drugs with goal of enhancing treatment for epilepsy. Scientists continue to study how neurotransmitters interact with brain cells to control nerve wiring and how non-neuronal cells in the brain contribute to seizures. One of the most-studied neurotransmitters is *GABA, or gamma-aminobutryic acid. Researchers are working to identify genes that may influence epilepsy. This information may allow doctors to prevent epilepsy or to predict which treatments will be most beneficial. Doctors are now experimenting with several new types of therapies for epilepsy, including transplanting fetal pig neurons into the brains of patients to learn whether cell transplants can help control seizures, transplanting stem cells, and using a device that could predict seizures up to 3 minutes before they begin. Researchers are continually improving MRI and other brain scans. Studies have show that in some case, children may experience fewer seizures if they maintain a strict diet - called the ketogenic diet - rich in fats and low in carbohydrates.

*EEGs - electroencephalograms - электроэнцефалограммы;

*GABA - gamma-aminobutryic acid - гамма – аминомасляная кислота;

* MRL – magnetic resonance imaging – магнито – резонансное изображение

Exercise 10. Answer the following questions.

1. What is damaged in Epilepsy?

2. Clusters of what cells in the brain signal are abnormally?

3. What problems may occur in epilepsy, when the normal pattern of neuronal activity becomes disturbed?

4. When may pilepsy develop?

5. When does epilepsy occur a patient ?

6. What are the most common diagnostic tests for epilepsy?

7. What new types of therapies for epilepsy are being experimented now?

8. What device can predict seizures in Epilepsy?

9. When may children experience fewer seizures?

10. How do we call a diet – rich in fats and low in carbohydrates?

Exercise 11. Put questions to the underlined members or parts of sentences.

1. Epilepsy is a brain disorder in which clusters of nerve cells, or neurons, in the brain sometimes signal abnormally.

2. In epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.

3. Anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development - can lead to seizures.

4. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, or some combination of these factors.

5. Only when a person has had two or more seizures is he or she considered to have epilepsy.

6. For about 80 percent of patients diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques.

7. Some antiepileptic drugs can interfere with the effectiveness of oral contraceptives.

8. Scientists are studying potential antiepileptic drugs with goal of enhancing treatment for epilepsy.

9. Scientists continue to study how neurotransmitters interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures.

10. Studies have show that in some case, children may experience fewer seizures if they maintain a strict diet - called the ketogenic diet - rich in fats and low in carbohydrates.

Exercise 12. Make up sentences according to the text.

1. Epilepsy, possible, with, disorder, is, many, a, causes.

2. Is, as, to, epilepsy, begin, as, once, diagnosed, is, treatment, soon, important, it, possible.

3. Are, identify, researchers, to, that, working, epilepsy, genes, influence, may.

4. Seizures, cause, not, most, brain, do, damage.

5. Contraceptives, drugs, with, interfere, some, can, effectiveness, the, antiepileptic, of, oral.

Exercise 13. Insert the prepositions and adverbs where it is necessary.

1. Epilepsy is a brain disorder … which clusters … nerve cells, or neurons, … the brain sometimes signal abnormally.

2. *EEGs and brain scans are common diagnostic test … epilepsy.

3. … about 80 percent … those diagnosed … epilepsy, seizures can be controlled … modern medicines and surgical techniques.

4. Most people … epilepsy lead … normal lives.

5. Researchers are … improving MRI and other brain scans.

Exercise 14. Fill in the blanks with the appropriate words given below:

1. … a disorder of the brain function characterized by recurrent seizures that have a sudden onset.

2. In epilepsy, the normal pattern of neuronal activity becomes …, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.

3. Epilepsy may develop because of … in brain wiring, an imbalance of nerve signaling chemicals called neurotransmitters, or some combination of these factors.

4. Having … does not necessarily mean that a person has epilepsy

5. … are common diagnostic test for epilepsy.

6. Once epilepsy… , it is important to begin treatment as soon as possible.

(*EEGs and brain scans; disturbed; a seizure; Epilepsy; an abnormality; is diagnosed).

Exercise 15. Translate into English, using active vocabulary:

1. Эпилепсия - это нарушение функции мозга, характеризующееся повторными приступами с внезапным началом.

2. При эпилепсии, когда нормальная структура нейронной активности нарушается, провоцируются незнакомые восприятия, эмоции, поведение, иногда конвульсии, мышечные спазмы, а также потеря сознания.

3. Всё то, что может нарушить нормальную структуру нейронной активности – от заболевания до повреждения мозга – может привести к эпилептическому приступу.

4. Только тогда, когда у пациента случалось два и более эпилептических припадка, можно полагать, что у пациента – эпилепсия.

5. Наиболее частыми диагностическими тестами при эпилепсии считаются электроэнцефалограммы и сканограммы головного мозга.

6. Как только устанавливается диагноз эпилепсии, необходимо как можно скорее начать лечение.

7. Большинство женщин с эпилепсией могут забеременеть, но при этом, они должны обсудить своё заболевание и сообщить о медикаментозном лечении, которое они принимают, со своим врачом.

8. Исследователи работают над тем, чтобы идентифицировать гены, которые могут влиять на эпилепсию.

9. Сейчас доктора экспериментируют с несколькими новыми типами лечения эпилепсии, включая трансплантацию эмбриональных нейроны свиней в мозг человека, трансплантацию стволовых клеток, а также использование устройства, которое сможет предупредить припадки за 3 минуты до их начала.

10. Известно, что при соблюдении строгой диеты, которая содержит большое количество жиров, но малое количество углеводов, можно избежать частых приступов эпилепсии.

Exercise 16. Give the summary of the text, according to the following questions.

What is Epilepsy?

Is there any treatment?

What research is being done?

TEST:

1. Epilepsy is a brain disorder in which… , or neurons, in the brain sometimes signal abnormally.

a. clots of nerve cells

b. clusters of nerve cells

c. fascicles of nerve cells

d. bundle of nerve cells

e. plexus of nerve cells

2. …epilepsy, the normal pattern of neuronal activity becomes disturbed, causing strange sensations, emotions, and behavior or sometimes convulsions, muscle spasms, and loss of consciousness.

a. At

b. On

c. In

d. Upon

e. Before

3. Anything that disturbs the normal pattern of neuron activity - from illness to brain damage to abnormal brain development -… .

a. can be lead to seizures

b. can leads to seizures

c. could lead to seizures

d. can lead to seizures

e. can to lead to seizures

4. Epilepsy may develop because of an abnormality in brain wiring, an imbalance of nerve signaling chemicals called… , or some combination of these factors.

a. neuroblasts

b. neurocytons

c. neurotachometers

d. neuroviruses

e. neurotransmitters

5. Only when a person …two or more seizures is he or she considered to have epilepsy.

a. has had

b. have had

c. had had

d. have been

e. have been had

6. …of those diagnosed with epilepsy, seizures can be controlled with modern medicines and surgical techniques.

a. For about 80 percent

b. For about 70 percent

c. For about 60 percent

d. For about 50 percent

e. For about 40 percent

7. …, the FDA approved the vagus nerve stimulator for use in people with seizures that are not well-controlled by medication.

a. In 1907

b. In 1987

c. In 1997

d. In 1917

e. In 1897

8. This information … epilepsy or to predict which treatments will be most beneficial.

a. may allow doctors to prevent

b. may allow doctors to prompt

c. may be allowed doctors to prevent

d. may be allow doctors to prevent

e. may allow doctors to prevent

9. Doctors are now experimenting with several new types of therapies for epilepsy, including transplanting fetal pig neurons into the brains of patients to learn whether cell transplants can help control seizures, transplanting stem cells, and using a device that could predict seizures….

a. up to 3 minutes after they begin

b. up to 3 minutes before they begin

c. up to 3 minutes before they complete

d. up to 23 minutes before they begin

e. to three minutes after they finish

10. Studies have show that in some case, children may experience fewer seizures if they maintain a strict diet - called … - rich in fats and low in carbohydrates.

a. the bland diet

b. the gluten-free diet

c. the sodium-restricted diet

d. the ketogenic diet

e. the unmeasured diet

K E Y S