Neuropathology

Question 1

What are potential causes of raised intracranial pressure?

Answer 1

• Increased CSF volume (hydrocephalus)
• Intracranial space-occupying lesion
  
  • neoplasm
  • haemorrhage
  • abscess
• Cerebral oedema

Question 2

What are potential causes of raised intracranial pressure?

Answer 2

• Herniation
  
  • Subfalcial (cingulate) herniation
  • Central/transtentorial herniation
  • Tonsillar/cerebellar herniation
• Tonsillar/cerebellar herniation may cause compression of the medulla with impairment of vital respiratory and cardiac functions.

Question 3

What is this an image of?

Answer 3

• Tonsillar Herniation at autopsy
  
  • Coning herniation and compression of the medulla oblongata
  • Duret Haemorrhages

Question 4

Give examples of Space occupying lesions

Answer 4

• Extradural/epidural haemorrhage
• Subdural haemorrhage
• Subarachnoid haemorrhage
• Intracerebral haemorrhage
• Ischaemic infarct with subsequent oedema or haemorrhage
• Neoplasm
• Abscess

Question 5

What types of head trauma are there?

Answer 5

• Skull fracture
• Parenchymal injury
  
  • Contusion (bruising) Concussion is a clinical term/syndrome
  • Laceration (penetration or tearing)
  • Diffuse axonal injury
• Coup and contrecoup
• Vascular injury

Question 6

What are the types of Vascular injury

Answer 6

• Extradural
  
  • Severe trauma with arterial laceration (m. mening. a.)
• Subdural
  
  • Trauma may be minor in atrophy (bridging veins)
• Subarachnoid
  
  • Rupture of saccular (berry) aneurysm (circle of Willis)
• Intracerebral (hypertension)

Question 7

What type of neuropathology is this?

Answer 7

• an extradural haemorrage on the left parietal lobe

Question 8

What type of neuropathology is this?

Answer 8

• a flattening of the temporal lobe caused by a Subdural haemorrhage

Question 9

What type of neuropathology is this?

Answer 9

Intracerebral Haemorrhage

Question 10

What type of neuropathology is this?

Answer 10

Subarachnoid Haemorrhage

Question 11

What are the types of Cerebral Oedema?

Answer 11

• Vasogenic: increased vascular permeability
• Cytotoxic: Neuronal, glial or endothelial cell damage

Question 12

What neuropathology is this?

Answer 12

Cerebral Ischaemic Infarct

Question 13

What would be seen in the histology of a cerebral ischaemic infarct?

Answer 13

• Acute neuronal injury
• ‘Red neurons’
• Pyknosis of nucleus
• Shrinkage of the cell body
• Loss of nucleoli
• Intense eosinophilia of cytoplasm
  
  • Owing to irreversible hypoxic/ischaemic insult

Question 14

Types of neurological Infections

Answer 14

• Meningitis
  
  • bacterial (acute or chronic)
  • viral
  • fungal
  • RMSV, neurosyphilis, Lyme disease, malaria
• Abscess
  
  • Usually bacterial
• Encephalitis
  
  • Viral (HSV, CMV, HIV, JC polyomavirus)
• Localised
  
  • Toxoplasmosis, cysticercosis

Question 15

What types of progressive/ degenerative conditions are there?

Answer 15

• Neurodegenerative diseases (Alzheimer d., Parkinson d.,)
• Spinocerebellar degenerative diseases
• Demyelinating diseases (Multiple sclerosis)
• Prion diseases (Creutzfeldt-Jakob disease)
• Genetic metabolic diseases (Neuronal storage diseases)
• Toxic & acquired metabolic diseases (Vit B1 & B12 def., CO toxicity, alcohol toxicity, radiation toxicity)