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Neuro path


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name first sx AD
loss recent memory, then loss of longterm memory and other intellectual
anatomic changes AD
-generalized cerebral atrophy esp frontal, hippocampal
-NF tangles,CTX
-neuritic (senile) plaques CTX, hippo, amyg
-granulovacuolar degeneration hippo
-amyloid angiopathy
Hirano bodies
decr neurons in nu baslais of Meynert
picks dz, present, anatom
progressive dementia more common in women
cerebral atrophy w gliosis and loss cortical neurons exp temporal and frontal
pick bodies in some cells, esp in horn of Ammon
anatomic changes in HD
atrophy, neuronal depletion, gliosis of caudate nuclei, putamen and frontal
anatomic changes in PD
neuronal depletion and depigment of cells in SN and locus, ceruleus
Lewy bodies
ALS clinical present
middle aged men, rapidly progressive UMN and LMN leading to death from respir failure
anatomic ALS
degen of lateral CS and anterior motor neurons of SC
neuritic plaques
what dz
made of
amyloid Abeta peptide, usu in cerebral cortex, hippocampus, amygdala
genetics of familial AD
APP chrom 21 codes for amyloid precursor-linked familial AD
presenilin1 (chrom 14), presenilin2 (chrom 1)
genetics of idio AD
e4 allele of ApoE chromo 19 seen more in AD
Wernicke triad
confusion, ataxia, ophthalmoplegia
NT problem in AD
low Ach
NT in PD
decr DA of Corpus Striatum
NT in HD
decr GABA, cholinergic
genetic HD
CAG trinucleo rpt (normal 11-34) HD (chrom 4). paternal transmission incr # rptd
how lacunar stroke present
motor OR sensory deficit (focal)
how HTN cause intracranial hemorr?
where occur?
form Charcot-Bouchard aneuryisms most often in BG/thal, also pons, Cb, frontal lobe white
MC place for emboli
how infarction brain characterized histol
liquef necrosis leading to cysst formation
rabies histol
perivascular accum of mono, Negri bodies in hippocampus and purkinje of Cb
prion dz transmitted by ritual ingestion of brain by cannibals in New Guinea, spongiform encephalopathy with Cb degen
potl hazard working w brain, (Creutsfeldt-Jakob)transmitted by corneal transplant?, mad cow dz beef,
ataxia, rapid progressive dementia, early death
usu caused by JC polyoma type Parvo. rapidly progressive mltpl foci demyelination seen in immune defic pts
haplotypes assoc MS
HLA A3, B7, DR2, DW2
Charcot triad
"classic" presentation MS: nystagmus, intention tremor, scanning speech
MS where are lesions
only CNS, likes paraventricular areas
Guillan Burre
acute inflam demyelin often after virus, immun, allergic rxn. ascending motor wknss and paralysis. albumin-cytologic dissoc of CSF increased protein w only sl incr cell ct
multiple oligonal bands
Werdnig Hoffmann dz
presents at birth as floppy baby w tongue fasciculation
tau protein
think AD
cauda equina syn
sensory saddle shape unilateral radicular pain, unilateral mscl atrophy and loss DTR quad and ankle
gradual onset
conus medullaris syn,
sensory bilateral saddle shaped, pain bilateral not severe, incontinence sex dysfxn,
sudden onset
usu intramedullary tumor
ventral artery occlusion
gets everything except DC
gets VWS, and ventral horns (LMN flaccid paralysis)
subacute combined degen (B12)
gets DC, CS, and SC
sx Brown-Sequard
at lesion: ipsi loss all sensation
ipsi motor paralysis and spast
ipsi loss DC
contra pain
glioblastoma histol
pseudopallisading with central necrosis, hemorr
glioblastoma epidemio, px
MC neoplasm of adults, px<1y
glioblastoma location
cerebral hemi, can cross CC, overall infiltrative w unclear border
meningioma, origin, location, px
from arachnoid cells, see around dura, 2nd MC adult neuro neo,
px: resectable!
histol meningioma
psammoma (spindle cells in whorls)
schwannoma, location, histol
CN8 (bilateral in NF2)
Antoni A=compact pallisading
Antoni B=loose pattern
presentation, location, px oligodendroglioma
(rare) present with sz, usu it's in the frontal, and is slow growing benign
histol oligodendroglioma
fried egg, often calcified
location ependymoma
arround ventricle met via CSF, well circumscribed,
has incr ICP
Cb pontine angle tumor damages what
majority child neuro tumors
infratemp, P fossa
pilocytic astro-descrip, location
benign, diffusely infiltrating glioma in P fossa (usu Cb)
characteristic histol pilocytic
Rosenthal fibers
medulloblastoma-epidemio, descrip, px
seen in children, it's a form of PNET in Cb, can compress 4thV lead to hydroceph. highly malignant but radiosensitive
name common adult neuro tumors
Pit adenoma
common child neuro tumors
pilo astro
histol of medulloblast
Rosette, perivascular pseudo rosette
common present ependymoma in children
4th v causing hydrocephalus
craniopharyngioma, epidemio, present, px, origin
MC, benign, can cause bitemp hemianopia, often calcified, from Rathke
compare cauda equina syn w conus medullaris
cauda equina is unilateral, gradual onset, and doesn't involve incontinence of sex dysfxn
conus medullaris is bilateral, sudden onset, w incontinence and sex dysfxn

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