Flashcards in Neuropathology Deck (66):
What part of the CNS is most vulnerable to hypoxic damage?
What damage to CNS is described here - activation of glutamate receptors results in uncontrolled calcium entry into cell, neurones cant use anaerobic glyclysis?
What is the term for a reaction within the cell body that is associated with axonal injury?
What is the most important histopathological indicator of CNS injury regardless of cause?
What happens to astrocytes in gliosis?
Undergo hyperplasia and hypertrophy
Disruption to what cells often associates with a local proliferation of sub-ependymal astrocytes to produce small irregularities on the ventricular surfaces termed ependymal granulations?
How much cardiac output does the brain recieve?
How much oxygen does brain consume?
20% of body oxygen
Blood is supplied to the brain via what two arteries?
Branches of internal carotid and vertebral arteries
What artery is affected with frontal lobe dysfunction, contralateral sesnory loss in foot and leg, paresis of arm and foot relative sparing of thigh and face?
Anterior cerebral artery
What artery is affected with hemiparesis, hemisensory loss, aphasia/dysphasia and apraxia?
Middle cerebral artery
What does vertebrobasilar - posterior supply (three things)?
Where does Webers syndrome affect?
Where does medial and lateral inferior pontine sundromes afect?
Where does lateral medullary syndrome affect?
Where is affected to cause homonymous hemianopia with macular sparing?
Where is affected to cause ataxia,. nystagmous, intention tremor and pendular reflexes?
Below systolic BP of what are autoregulatory mechanisms inadequate to compensate leading to parenchymal injury?
What are watershed areas (hypoxic ischaemic damage)?
Junctions of arterial territories which are first to be deprived of blood
What is the term for sudden disturbance of cerebral function of vascular origin that causes death or lasts over 24 hours?
What is the most common type of stroke?
Infarction - thrombotic
Most common cause of spontaneous subarachnoid haemorrhage?
Berry aneurysm rupture 90& in internal carotid artery territory
What is associated with severe headache, vomiting and loss of consciousness?
What is associated with lacunes - small cavities found in basal ganglia, thalami and pons of elderly?
Hypertension and the brain
What disease has primary demyelination?
What three toxins can cause demyelination?
Cyanide, CO, solvents
What type of demyelination are central pontine myelinosis, progressive multifocal leucoencephalopathy, subacute sclerosing panencephalitis, AIDS and axonal degeneration?
What is the most common demyelinating disease?
What sort of episodes does multiple sclerosis cause?
Relapsing and remitting flare up episodes
What is the morphology like in multiple sclerosis?
External appearance of brain and spinal cord usually normal, cut surface shows multiple areas of demyelination termed plaques
What matter does MS affect?
well-demarcated plaques in white matter?
What CN is MS commonly seen in?
What type of MS has yellow/brown demyelinated plaques with an ill-defined edge which blends into surrounding white matter?
What type of MS has plaques that are well demarcated, grey/brown lesions in white matter and classically sit around lateral ventricles?
What patholkogical condition can huntingtons disease and picks disease cause?
In Alzheimers disease what happens to the macroscopic pathology of the brain?
Decreased size and weight - cortical atrophy
In Alzheimers disease what happens to the macroscopic pathology of sulci?
In Alzheimers disease what happens to the macroscopic pathology of gyri?
What lobes are affected in Alzheimers?
What happens to brainstem and cerebellum in alzheimers?
What disease has intracytoplasmic neurofibrillary tangles, Amyloid plaques (extracellular senile or neuritic plaques), amyloid angiopathy and extensive neuronal loss with astrocytosis?
What protein is affected with neurofibrillary tangles in Alzheimrs?
What colour does perivascular amyloid stain in Alzheimers?
What are the hallmarks of dementia with Lewy bodies?
Hallucinations and fluctuating levels of attention
What is degenerated in dementia with Lewy bodies - same as PD?
Name a neuropsychiatric disorder, onset common between 35-50 but can occur anytime?
What is the hungtintons disease triad?
1. Emotional disturbance
2. Cognitive disturbance
3. Motor disturbance
Chorea, myoclonus, clumsiness, slurred speech, depression, irritability and apathy?
Hungtintons disease - develop dementia later
What disease has teh microscopic appearance of loss of neurons in caudate nucleus and cerebral cortex accompanied by reactive fibrillary gliosis?
A progressive dementia commencing in middle life (usually between 50 and 60 years) characterised by slowly progressing changes in character and social deterioration leading to impairment of intellect, memory and language
What two lobes suffer extreme atrophy in picks disease?
Frontal and temporal
What are the histological hallmarks of Pick's disease?
Pick's cells (swollen neurons)
Pick's bodies (intracytoplasmic filamentous inclusions
What disease gives personality and behavioural changes, speech and communication problems, changes in eating habits and reduced attention span?
What four things seperate multiinfarct dementia from Alzheimers?
1. Abrupt onset
2. Stepwise progression
3. History of hypertension/stroke
4. Evidence of stroke seen on CT or MRI
What is hydrocephalus?
Accumulation of excessive CSF within the ventricular system of the brain
What is the normal volume of CSF?
120 to 150ml
Where is CSF produced?
In choroid plexus in lateral and fourth ventricles of brain
What absorbs CSF?
What foramina does CSF travel through to get to the cisterna magna?
Foramina of Luschka
Foramina of Magendie
Where does non-communicating hydrocephalus occur?
Within ventricular system
Where does communicating hydrocephalus occur?
Outside ventricular system e.g. in SA space or at arachnoid granulations
What are the four most common herniation routes due to an increase in ICP?
What are the most primary intracerebral tumours?
Gliomas - most commonly astrocytoma