Neuropathology

Question 1

Normal Pressure Hydrocephalus

Answer 1

Abnormal buildup of CSF
Cause:Idiopathic or secondary to head trauma, infection, subarachnoid hemmorrhage.
CS&S: Gait abnormality, (Gait Apraxia) cognitive disturbances, urinary incontinence.
Treatment: large volume lumbar puncture, or shunt.

Question 2

Gait Apraxia

Answer 2

Muscles and innervation are normal, but patient has an inability to perform a learned act correctly.

Question 3

Stroke

Answer 3

Interruption of blood flow to the brain.

Question 4

Risk factor for stroke

Answer 4

High BP
Diabetes
Heart Disease
Smoking
Age
Gender
Race/Ethnicity
Family
Brain Aneurysms
Arteriovenous malformations

Question 5

CS&S of a Stroke

Answer 5

Sudden Weakness
Sudden Severe Headache
Paralysis
Difficulty Speaking
Difficulty Breathing
Lack of coordination
Difficulty seeing
Confusion

Question 6

Ischemic Stroke

Answer 6

Blood clot occludes blood flow

Question 7

Hemorrhagic Stroke

Answer 7

Blood vessel bursts

Question 8

Transient Ischemic Attack

Answer 8

TIA
“Mini Stroke”
Same CS&S as a stroke
Symptoms resolve within an hour

Question 9

Treatment of Stroke

Answer 9

Tissue plasminogen activator (must be used within 4 hours of symptoms, or risk of hemmhorage increases.

Question 10

Glial Cell tumors

Answer 10

Most prominent cell type in CNS

CS&S: Repetetive headaches, elevated ICP, Seizures,.

Question 11

Treatment of Glial Cell

Answer 11

Surgery, Radiation, Chemo, Steroids

Question 12

Glioblastoma Multiforme

Answer 12

Most common primary brain tumor
Stage 4
Commonly found in the frontal and temporal lobes
Butterfly shaped
Arises from Astrocytes

Question 13

Ologodendroglioma

Answer 13

Arises from oligodendroblasts
Benign tumor
accounts for 5% of Gliomas
50% of cases calcify

Question 14

Ependymoma

Answer 14

Benign tumor, typically within the ventricles.
Arise from ependymal cells
Most common gliomas in the spinal cord.

Question 15

Meningiomas

Answer 15

Most commonly associated with the arachnoid mater
Slow growing
Mesenchymal in origin

Question 16

Pituitary adenomas

Answer 16

Most common tumors of pituitary gland
Alter growth hormones
Neoplastic cells look/function like host cells
Represents 8% of primary brain tumors

Question 17

Lymphoma

Answer 17

Unique: grow adjacent to ventricular structures
Arises from B lymphocytes
Can be controlled with chemo/radiation

Question 18

Medulloblastoma

Answer 18

Represent 7% of primary brain tumors
Can metastasize via CSF
Arise exclusively in the cerebellum from cells in the granular layer of the cortex

Question 19

Brain Metastases

Answer 19

Can occur from a variety of tumor types. Most commonly, Lung, breast, carcinoma, and melanoma.
Some have a tendency to hemorrhage, most commonly lung cancer.

Question 20

Pediatric Brain Tumors

Answer 20

Most common in posterior fossa.

Question 21

Mass Effect

Answer 21

Displacement of brain tissue due to intracranial event such as hemorrhaging or tumor growth.
Due to increase in ICP
Resulting deficits, herniation syndromes.

Question 22

Herniation Syndrome

Answer 22

Types: 
Subfalcine
Uncal
Central
Tonsillar

Question 23

Subfalcine Herniation

Answer 23

Cingulate herniation
Mass effect in the supratentorial compartment.
Forces cingulate gyrus under/against the falx cerebri.
Occurs more frequently in superior portions of the hemisphere, such as the parietal lobe or the parieto-frontal area
CS&S: inability to recall memory, or form new.

Question 24

Central Herniation

Answer 24

Diencephalic stage

Transtentorial herniation

Question 25

Diencephalic Stage

Answer 25

Expanding mass in the frontal, parietal, or occipital lobe.