Lobes of the Brain

The three main components of the brainthe cerebrum, the cerebellum, and the brainstemhave distinct functions. The cerebrum is the largest and
most developmentally advanced part of the human brain. It is responsible for several higher functions, including higher intellectual function, speech,
emotion, integration of sensory stimuli of all types, initiation of the final common pathways for movement, and fine control of movement.
The cerebellum, the second largest area, is responsible for maintaining balance and further control of movement and coordination.
The brain stem is the final pathway between cerebral structures and the spinal cord. It is responsible for a variety of automatic functions, such as
control of respiration, heart rate, and blood pressure, wakefullness, arousal and attention.
The cerebrum is divided into a right and a left hemisphere and is composed of pairs of frontal, parietal, temporal, and occipital lobes.
The left hemisphere controls the majority of functions on the right side of the body, while the right hemisphere controls most of functions on the left
side of the body The crossing of nerve fibers takes place in the brain stem. Thus, injury to the left cerebral hemisphere produces sensory and motor
deficits on the right side, and vice versa.
Layers of the Cerebrum Gray and White Matter
The entire cerebrum is composed of two layers. The 20-millimeter thick outermost layer, called the cerebral cortex (or gray matter), contains the
centers of cognition and personality and the coordination of complicated movements. As shall be seen, the gray matter is also organized for different
functions.
The white matter is a network of fibers that enables regions of the brain to communicate with each other.
Cerebellum and Brainstem
A stroke involving the cerebellum may result in a lack of coordination, clumsiness, shaking, or other muscular difficulties. These are important to
diagnose early, since swelling may cause brainstem compression or hydrocephalus.
Strokes in the brainstem are usually due to basilar occlusion, although in many cases the clinical syndrome may fit the criteria for a lacunar stroke
[Mohr JP and Sacco RL, 1992]. Brainstem strokes can be serious or even fatal. People who survive may be left with severe impairments or remain in
a vegetative state.

Family History as a Risk Factor for Carotid Artery Stenosis
1. Mahyar Khaleghi, MD,
2. Iyad N. Isseh, MBBS,
3. Hayan Jouni, MD,
4. Sunghwan Sohn, PhD,
5. Kent R. Bailey, PhD and
6. Iftikhar J. Kullo, MD
Abstract
Background and PurposeWe investigated whether family history of stroke or coronary heart disease (CHD) is
associated with presence of carotid artery stenosis (CAS).
MethodsThe study cohort included 864 patients (728 years; 68% men) with CAS and 1698 controls (6111 years;
55% men) referred for noninvasive vascular testing. CAS was defined as 70% stenosis in the internal carotid artery on
ultrasound or history of carotid revascularization. Controls did not have CAS or history of cerebrovascular disease or
CHD. Family history of stroke and CHD was defined as having 1 first-degree relative who had stroke or CHD before age
65 years. Logistic regression analysis was used to evaluate whether family history of stroke or CHD was associated with
presence of CAS, independent of conventional risk factors.
ResultsFamily history of stroke and CHD was present more often in patients with CAS than in controls, with a
resulting odds ratios (95% confidence interval) of 2.02 (1.612.53) and 2.01 (1.702.37), respectively. The associations
remained significant after adjustment for age, sex, body mass index, smoking, diabetes mellitus, hypertension, and
dyslipidemia; odds ratios: 1.41 (1.061.90) and 1.69 (1.352.10), respectively. A greater number of affected relatives with
stroke or CHD was associated with higher odds of CAS; adjusted odds ratios: 1.25 (0.911.72) and 1.46 (1.141.89)
versus 2.65 (1.355.40) and 2.13 (1.572.90) for patients with 1 and 2 affected relatives with stroke and CHD,
respectively.
ConclusionsFamily history of stroke, and of CHD were each associated with CAS, suggesting that shared genetic and
environmental factors contribute to the risk of CAS.
Key Words:
atherosclerosis
carotid stenosis
coronary heart disease
risk factors
stroke
Received June 4, 2014.
Revision received June 4, 2014.
2014 American Heart Association, Inc.


http://stroke.ahajournals.org/content/early/2014/07/08/STROKEAHA.114.006245.abstract








Effects of intravenous administration of allogenic bone marrow- and adipose tissue-
derived mesenchymal stem cells on functional recovery and brain repair markers in
experimental ischemic stroke
Mara Gutirrez-Fernndez1

, Berta Rodrguez-Frutos1

, Jaime Ramos-Cejudo1, M Teresa Vallejo-

Cremades1, Blanca Fuentes1, Sebastin Cerdn2 and Exuperio Dez-Tejedor1
*

*Corresponding author: Exuperio Dez-Tejedor edieztejedor@hotmail.com
Equal contributors
Published: 28 January 2013
Abstract
I ntroduction
Stem cell therapy can promote good recovery from stroke. Several studies have demonstrated that mesenchymal stem
cells (MSC) are safe and effective. However, more information regarding appropriate cell type is needed from animal
model. This study was targeted at analyzing the effects in ischemic stroke of acute intravenous (i.v.) administration of
allogenic bone marrow- (BM-MSC) and adipose-derived-stem cells (AD-MSC) on functional evaluation results and brain
repair markers.
Methods
Allogenic MSC (2 10
6
cells) were administered intravenously 30 minutes after permanent middle cerebral artery
occlusion (pMCAO) to rats. Infarct volume and cell migration and implantation were analyzed by magnetic resonance
imaging (MRI) and immunohistochemistry. Function was evaluated by the Rogers and rotarod tests, and cell proliferation
and cell-death were also determined. Brain repair markers were analyzed by confocal microscopy and confirmed by
western blot.
Results
Compared to infarct group, function had significantly improved at 24 h and continued at 14 d after i.v. administration of
either BM-MSC or AD-MSC. No reduction in infarct volume or any migration/implantation of cells into the damaged
brain were observed. Nevertheless, cell death was reduced and cellular proliferation significantly increased in both
treatment groups with respect to the infarct group. At 14 d after MSC administration vascular endothelial growth factor
(VEGF), synaptophysin (SYP), oligodendrocyte (Olig-2) and neurofilament (NF) levels were significantly increased
while those of glial fiibrillary acid protein (GFAP) were decreased.
Conclusions
i.v. administration of allogenic MSC - whether BM-MSC or AD-MSC, in pMCAO infarct was associated with good
functional recovery, and reductions in cell death as well as increases in cellular proliferation, neurogenesis,
oligodendrogenesis, synaptogenesis and angiogenesis markers at 14 days post-infarct.
http://stemcellres.com/content/4/1/11/abstract