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Flashcards in Neuropathology Deck (40):
1

How can infections get into the brain?

Direct Spread (Otitis Media)
Blood (Septicaemia)
Iatrogenically (LP)

2

What can infections in the brain cause?

Meningitis
Encephalitis
Abcess
Chronic Meningitis

3

What are the Pathogens for different types of Encephalitis?

Spinal Cord - Polio
Temporal Lobe - Herpes
Brainstem - Rabies

4

What is Encephalitis?

Infection and inflammation of the neuronal cell bodies.
Can lead to cell death and formation of inclusion bodies

5

What is "chronic" meningitis?

Different Pathogen
Causes Granulomatous disease, fibrosis, nerve entrapment

6

How can you get an abcess in the brain?

Via inner ear infection --> Internal auditory meatus --> temporal lobe

7

What are some consequences of meningitis?

Systemic --> Sepsis
Subdural Empyema
Herniation due to raised ICP --> death
Infarction
Abcess
Epilepsy

8

What is Prion Disease?

Accumilation of mutated prion proteins which damage cell bodies.
This creates holes in the grey matter.

9

How do you get Prion Disease?

Exposure to Prions themselves from food, sporadic mutation, or can be familial

10

What is a spongiform encephalopathy?
What do you get it in?

Prion Disease

11

What can Prion Disease Cause?

Creutzfeldt Jakob Disease

12

What symptoms do you get with CJD?

Memory Lapses
Mood Changes
Hypertonia
Loss of Interest
Incontinence
Clumsiness

13

What is Dementia?

An acquired global impairment of brain function, that does not cause a loss of consciousness

14

What is Lewy Body Dementia?

Caused by accumilation of misfolded proteins which aggregate and form Lewy Bodies.
Leads to loss of attention and alertness

15

What are the types of dementia?

Alzheimers
Lewy Body
Vascular Dementia
Picks Disease

16

What is Alzheimers?

Dementia caused by neuronal damage (forming Tangles and Plaques) and loss of neurotransmitters.
This leads to atrophy of brain tissue

17

What is a plaque?

Aggregation of amyloid with enlarged axons, dendrites and synaptic terminals

18

What is a tangle?

Tau proteins are hyper phosphorylated and twist together

19

What is the survival rate of Alzheimers

7 to 10 years

20

Early signs of AD?

Forgetfulness

21

Later signs of AD?

Confusion
Agitation

22

Can we treat AD?

We can limit early symptoms and delay progression with AChE inhibitors

23

What is Vascular Dementia?

Dementia caused by a loss or problem with the blood supply to the brain
It can be multi-infarct, post-stroke, subcortical or mixed with AD

24

What are the signs of vascular dementia?

CVS risk factors
Memory is less affected early on
Problems with following instructions/cognition

25

Can we treat V Dementia?

We can manage the CVS risk factors to prevent progression

26

What is Picks Disease?

Fronto-temporal dementia caused by a build up of abnormal proteins
It has no treatment

27

What are the symptoms of Picks Disease

Get behavioural and personality changes (loss of inhibition) and speech difficulties

28

What is a raised intracranial pressure?

Sustained over 20mmHg

29

What can cause a raised ICP?

An abcess
Hydrocephalus
SOL
Tumour
Haemorrhage
Infection

30

What can happen in an enlarging SOL?

Increasing ICP leading to Herniation

31

What are the types of herniation?

Subfalcine
Tentorial/Uncal
Tonsillar

32

What are the benign tumours of the brain?

Meningioma

33

What are some malignant brain tumours?

Astrocytoma
Neurofibroma
Ependymyoma
Metastasis (most common)
Lymphoma

34

Describe a subfalcine herniation

There is a SOL on the same side, the cingulate gyrus is forced underneath the falx cerebri to the other side of the brain
This can compress the ACA and lead to ischaemia of the brain

35

Describe a uncal/tentorial herniation

The parahippocampal gyrus is forced underneath the tentorial notch by a lesion above it.
This can compress CNIII, the PCA and the SCerebellarAs

36

Describe a tonsillar herniation

Raised ICP leads to the cerebellar tonsils herniating through the foramen magnum of the skull and compressing the brainstem
Leads to death

37

What is tonsillar herniation also known as?

Coning

38

What can happen secondary to a tentorial herniation?

A duret herniation into the brainstem

39

What is a lacunar infarct?

Less than 1cm
Commonly in the Basal Ganglia
Associated with Hypertension

40

What is a regional infarct?

An infarct in a cerebral or carotid artery