Pathology(CNS)
Terms
undefined, object
copy deck
- Hemorrhage into the mammilary bodies & dorsal medial gray matter around the cerebral aquaducts
- Wernicke-Korsakoff Synd
- Confusion, paralysis of the lateral rectus, & ataxia w/ memory loss & confabulation
-
Wernicke-Korsakoff Synd.
-caused by thiamine def., typically in alcoholics - Meningitis w/ inc. mononuclear cells, normal or inc. protein, and normal glucose in CSF
- Acute aseptic(viral)meningitis
- Neurofibrillary tangles & senile Beta-amyloid plaques in elderly px.
-
Alzheimer Dse.
-assoc. w/ mutations on chromosomes 21,19,14, & 1 - Common neurodegenerative diseases w/ dementia
- Alzheimer disease, Hungtington dse., & Pick dse.
- Degeneration of the upper & lower motor neurons of the lateral & ventral corticospinal tracts
-
Amyotrophic Lateral Sclerosis(ALS)
-assoc. w/ mutations of superoxide dismutase - Most common cause of cerebral embolic infarcts
-
Cerebral atherosclerosis
-most common location is the middle cerebral arterty - Changes in memory & behavior followed by rapid dementia w/ startle myoclonus
-
Creutzfeld-Jakob Dse.
-histologically characterized by spongioform change; transmission via prion protein - Rupture of middle meningeal artery bec. of skull fracture
-
Epidural Hematoma
-can be fatal - Most common primary intracranial neoplasm
-
Glioblastoma Multiforme
-as opposed to the most common intracranial neoplasm overall w/c is metastases to the brain - Pseudopalisading arrangement of malignant nuclei
- Glioblastoma Multiforme
- Patients present w/ involuntary kerky movements or writhing of the ext.
-
Huntingyon dse.
-autosomal dominant dse. assoc. w/ trinucleotide repeat expansions - Atrophy of the caudet, putamen, and globus pallidus
-
Huntington Dse.
-caudate atrophy leads to "bat wing" lateral ventricles - Most common cause of primary brain parenchymal hemorrhage
- Hypertension
- One of the most common intracranial tumors in children
- Medulloblastoma
- Tumor pushes on(rather than infiltrates) adjacent parenchyma
-
Meningioma
-slow growing & often surgically resectable - Charcot triad: nystagmus, intention tremor, & scanning speech
-
Multiple Sclerosis
-in a gross specimen, dirty tan periventricular plaques indicate demyelination in white matter - Assoc. w/ folate def. during the initial weeks of gestation
-
Neural Tube Defect
-alpha-fetoprotein level is elevated in maternal serum - Multiple neurofibromas on the skin, café au lait spots, & Lisch nodules(pigmented hamartomas) on the iris
-
Neurofibromatosis(Type 1)(Von Recklinghausen dse.)
-autosomal dominant mutation in the
NF-1 gene - Rigid expressionless face & a pill-rolling tremor
- Parkinson Dse
- Atrophy & gross depigmentation of the dopamine-producing cells of the substancia nigra & locus coeruleus
-
Parkinson Dse.
-histologically charact. by Lewy bodies w/c are intracytoplasmic, eosinophilic inclusions w/ in neurons - Spinal tap w/ numerous leukocytes, dec. glucose & inc. protein
- Bacterial(Pyogenic) Meningitis
- Most common cause of subarachnoid hemorrhage
-
Rupture of a berry aneurysm
-most common location of berry aneurysms is the Circle of Willis - Intracranial Tumor presenting w/ tinnitus & hearing loss
-
Schwannoma(acoustic neuroma)
-involves CN VII & VIII at the cerebellopontine angle - "Worst headache of my life", vomiting, loss of consciousness, & blood in the CSK
- Subarachnoid hemorrhage
- Intracranial hemorrhage due to disruption of the bridging veins
- Subdural hemorrhage
- Loss of pain & temperature sensation in the upper ext.
- Syringomyelina
- Weakness, parasthesia, & "pins-and-needles" feeling
-
Vit. B12 Def.
-affects the lateral & post. columns - Cerebrovascular dse. charact. by liquefactive necrosis leading to cyst form. due to arterial occlusion from thrombosis(due to atherosclerosis) or embolism(from cardiac mural thrombi, vegetations of infected endocarditic valves,clumps of tumor cells,bubbl
-
Infarction
-embolism is much less common thrombosis - Denotes inc. vol. of CSF w/ in the cranial cavity;assoc. w/ enlargement of the skull;often due to obstruction to CSF flow by different mech.(congenital malform.,inflam.,tumors) or by overproduction of CSF by choroid plexus papilloma
-
Hydrocephalus
-types:internal(inc. CSF w/ in the vent.),external(inc. CSF w/ in the subarachnoid space),communicating(free flow of CSF betw. the vent. & subarachnoid space),noncommunicating(obstructed flow betw. vent. & subarachnoid space) - Type of hydrocephalus w/c occurs w/o obstruction or inc. CSF production in disorders charact. by dec. cerebral mass,such as ischemic brain atrophy or advanced Alzheimer dse.
- Hydrocephalus ex vacuo
- A downward displacement of the cerebellar tonsils & medulla through the foramen magnum charact. by presence of a thoracolumbar meningomyelocele~ pressure atrophy of displaced brain tissue~obstrusction of CSF flow~ hydrocephalus
- Arnold-Chiari malformation
- Congenital disorder of the CNS charact. by facial abn° & developmental defects such as microcephaly,atrial septal defect,mental & growth retardation,& other anomalies;assoc. w/ excessive maternal alcohol intake during pregnancy
- Fetal Alcohol Synd.
- Congenital CNS disorder charact. by seizures & mental retardation beginning in infancy w/c includes adenoma sebaceum of the skin & angiomyolipoma of the kidney
-
Tuberous Sclerosis Synd.
-includes autosomal dominant nodular proliferation of multinucleated atypical astrocytes forming tubers(small white nodules scattered in the cerebral cortex & periventricular areas) - Most common group of CNS disorder, ranking after heart dse. & cancer as 3rd major cause of death in the U.S
-
Cerebrovascular Dse.
-2 major types:Infarction(thrombosis, embolism)& Hemorrhage(intercerebral, subarachnoid) - Group of disorders charact. by failure of closure of the neural tube;assoc. w/ increased conc. of alpha-feto-protein in amniotic fluid or maternal serum & maternal folic acid def.
-
Neural Tube Defects
-types(Spina bifida,Spina bifida occulta,Spina bifida cystica, Meningocele,Meningomyelocele, Anencephaly) - Neural tube defect due to failure of posterior vertebral arches to close
- Spina bifida
- Spina bifida w/ no clinically apparent abn°;vertebral arch defect most limited to one or two vertebrae
- Spina bifida occulta
- Neural tube defect due to herniated membranes consisting of meninges only
- Meningocele
- Neural tube defect w/ marked diminution(sometimes absence)of fetal brain tissue;usually assoc w/ the absence of overlying skull
- Anencephaly
- Group of infxn. transmitted from the mother to the fetus w/ similar clinical manifestations w/c involves the heart,skin,eye,& CNS;causes chorioretinitis;charact. by microcephaly & focal cerebral calcification
-
TORCH complex
-stands for TOxoplasma,Rubella, Cytomegalovirus,& Herpes simplex virus - Most common site of vascular obstruction in cerebrovascular dse. due to thrombosis & embolism resulting in contralateral paralysis as well as motor & sensory defects & aphasias
- Thrombosis(carotid bifurcation & middle cerebral artery) & Embolic(middle cerebral artery)
- Type of stroke caused by an obstruction of small vessels~small lesions(upon healing are recognized as lacunae,small pits)
-
Lacunar Strokes
-focal;purely sensory(affecting the thalamus) or motor(affecting the internal capsule) - CNS hemorrhage w/c consist of bleeding into the subarachnoid space;assoc. w/ berry aneurysm of the circle of Willis; caused by arteriovenous malformations, trauma,or hemorrhagic diatheses
- Subarachnoid Hemorrhage
- Cerebrovascular dse. charact. by brief episodes of impaired neurologic function caused by temporary disturbance of cerebral circl.;not assoc. w/ permanent damage but are considered precursors to more serious occlusive events
- Transient Ischemic Attacks(TIAs)
- Arterial hemorrhage assoc. w/ skull fracture & laceration of branches of middle meningeal artery;charact. by short period of consciousness(lucid interval)followed by rapidly developing signs of cerebral compression
-
Epidural Hematoma
-amenable to emergency surgical intervention due to bleeding into the brain substance itself does not occur