Histopathology - Cerebrovascular disease and trauma

Question 1

Two types of oedema

Answer 1

Vasogenic

Cytotoxic -ischaemic damage to astrocyte end foot processes - APA4 found in the brain

Question 2

Two forms of hydrocephalus

Answer 2

o Non-Communicating
 Obstruction to the flow of CSF
 Usually involving the cerebral aqueduct

o Communicating
 No obstruction
 Problems in reabsorption of CSF into venous sinuses (e.g. meningitis)

Question 3

Haemorrhagic stroke

Answer 3

intracerebral
intraventricular
SAH (most common)

Excludes
Epidural
subdural
haemorrhage caused by tumour

Question 4

Commonest cause of haemorrhagic stroke

Answer 4

htn

most common in the basal ganglia

Question 5

Complication of arteriovenous malformation and management

presentation

Answer 5

high pressure massive bleed – can cause haemorrhagic stroke

surgery
radiosurgery
embolization

haemorrhage headache seizures focal neurological deficit

Question 6

Arteriovenous malformation vs Cavernous angioma

Answer 6

Both
Developmental abnormality
can be found anywhere in the CNS
might present with haemorrhage, headache, seizures, focal neurological deficit

Arteriovenous malformation
High pressure massive bleed
brain substance/parenchyma wrapped up amongst the vessels
MRI in AVM has no black ring around lesion
surgery, radiosurgery, embolization

Cavernous angioma
low pressure recurrent bleed
no brain substance/parenchyma interposed between vascular spaces
target sign on MRI - black ring around lesion
surgery

Question 7

Commonest cause of SAH

Answer 7

Rupture of berry aneurysm

80% occur at carotid artery bifurcation

Mx
endovascular coiling
Clipping aneurysm

Question 8

Stroke

infarct vs haemorrhage

Answer 8

infarct - permanent damage in affected area, no recovery

haemorrhage - limited tissue damage, partial recovery

Question 9

Commonest cause of coma after trauma

Answer 9

Diffuse axonal injury

Question 10

rotational component of injury will result in damage of

Answer 10

midline structures

corpus callosum
brainstem
septum pellucidum (membrane lying between the ventricles)

Question 11

MRI based grading of DAI

Answer 11

1 lobar white matter, cerebellum

2 corpus callosum +/-lobar white matter

3 brainstem +/- lobar white matter

DAI is a radiological dx which can only be confirmed on post mortem