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Path neurology Flashcards

1
Q

Describe the neuronal body response to injury ?

A

Neuro response to injury
Neurons are the most vulnerable cell in the body to injury
- this is due to there size and inability to store glucose.

The response
Hallmark = Eosinophilic and shrunken
- ischaemic change (acute necrosis
- axons of degenerated ischaemic neurons may also release = glutamate
Glutamate causes injury to nearby neurons via calcium influx into the cell. (Neuroexcitatory).

Pigments and inclusions
Viral inclusions eg canine distemper
Lipofusin - increases with age (periodic Schiff (PAS) positive brown/golden pigment.
Hereditary lysosomal storage disease eg glycogen

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2
Q

Describe the response of the axon to injury in the CNS ?

A

Wallerian degeneration / axonal injury

Clinical signs
Digestive chambers - large empty spaces and macrophages
- swoolen axons = spheroids
- swollen, degeneration axon and myelin
- wont always be viewed as continuous
- fragment “ellipsoids”

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3
Q

Describe why there is a greater chance of recovery from axonal damage in the PNS than the CNS ?

A

PNS: Wallerian degeneration more likely to recover

Regeneration will occur given time and close apposition, peripheral nerves can regrow and restory function
- rapid phagocytosis of debris
- endoneuronal tube to guide axon regrowth
- Schawn cells can remyelinate axon

No repair of CNS eg spinal cord
- CNS myelin is chemically and antigenically different from PNS
- axon budding is inhibited by CNS myelin proteins
- oligodendrocyte arrangement prevents re myelination
- no endoneuronal tube to guide regrowth

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4
Q

Describe the function and injury of Astrocytes ?

A

Astrocytes
Function
- Naked nuclei no cytoplasm
- structural support and regulation
- repair (similar role to fibrocytes)
- foot processes: blood brain barrier

Response to injury
- proliferation, incrase in number
- attempt to wall off foreign body but incomplete
- hypertrophy
- acuteswelling
- Cytoplasm becomes visible (Gemistocytes)

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5
Q

Describe the response of Oligodendrocyte cells to injury ?

A

Oligodendrocytes
Function
- small dense cell
- produce myelin CNS
- each axon has only one cell

Acute swelling and degeneration
“satellitosis
- hypertrophy
- proliferation of precursor cells

Serious consequences
Selective myelin degeneration - primary demyelination
primary - viruses
seconday - axonal injury or death

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6
Q

Describe the response of Glia cells to injury ?

A

Glial cells
Immune surveilance / phagocytic

In response to injury
They are the first cells to respond to CNS injury
- proliferation
- Phagocytosis (neurons, myelin debris)
- Roles in inflammation ( antigen presentation, cytokine production).

Phagocytosis “Gitter cells”

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7
Q

Describe the layers of the meninges ?

A
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8
Q

Identify this lesion within the brain and describe its pathology and clinical signs ?

A

Hydrocephalus
(Fluid filled dilation of the brain)

Location depends upon the site of blockage
- obstruction within the ventricular system is most common
- affects ventricles &/or subarachnoid space
- causes pressure atrophy of ependymal cells and underlying brain

The cause is congenital
-can result from intrauterine infections (parainfluenza in dogs)
- injury of the ependymal cells of the aqueduct)
- genetic predisposition in brachycephalic

Clininical signs
doming of cranium
prominent frontanelles

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9
Q

Identify this lesion and describe its pathology ?

A

Hydromyelia

  • Fluid filled dilation of the central canal in the spinal cord
  • CSF accumulates in the cavity
  • usually from damage to ependymal cells and altered CSF flow
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10
Q

Identify the lesion (black arrow), and describe its pathology ?

A

Porencephaly

Small fluid filled cyst in the ceerebral hemispheres

Path
Destruction of immature neuroblast during development
eg virus Akabane, Border disease or bluetoungue

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11
Q

Identify this lesion and describe its pathology ?

A

Hydranencephaly
Large fluid filled cavities in the brain

  • this is a more severe form of porencephaly
  • failure of cerebral hemispheres to develop
  • ventricles expand into space
  • fill with CSF
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12
Q

Identify this lesion and describe its potential pathology ?

A

Cerebellar hypoplasia

The most common causes
* Viruses
Destroy dividing germinal cells of external granular layer of the cerebellum during organogenesis.

  • Parvoviruses
    Cats = panleukopaenia
    Dogs = parvovirus
  • Pestiviruses
    Calves: BVDV
    Piglets: Classical swine fever
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13
Q

Identify this lesion ?

A

Lissencephaly (Agyria)

= Lack of gyri
- smooth cortical surface
- genetic defect in neuronal migration
- DDX some species lack gyri.

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14
Q

Define Anencephaly ?

A

Anencephaly

A complete absence of the whole brain
- very rare
- often cerebral hemispheres missing cerebral aplasia

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15
Q

Identify this lesion and describe its pathology ?

A

Cranium bifida
Dorsal midline cranial defect

Meningeal +/- brain tissue can protrude
- meingococele and meningoencephalocoele
- genetic in pigs and cats
- Griseofulvin in 1st week of pregnancy in cats.

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16
Q

Identify this lesion and describe its pathology ?

A

Spina bifida

Dorsal vertebral arch defects
- often caudal spine affected
- meninges +/- spinal cord can protrude
- meningocoele and meingomyelocoele

17
Q

Describe Spinabifida occulta ?

A

Spinabifida occulta

Absence of skin over the vertebral arches but no herniation
- horses, calves, sheep

18
Q

Identify this lysosomal storage disease ?

A

Glycogenosis
Lysosomal storage disease

Pompe’s disease = deficiency alpha 1,4 glucosidase

19
Q

Describe the pathology and clinical signs underlying Pompe’s disease ?

A

Glycogenosis

Pathology
Pompe’s disease of Brahmans and shorthorns
- deficiency of alpha 1,4-glucosidase

Lesions
large neurons of brainstem and spinal cord
- skeletal muscle vacuolation and degeneration

Clinical signs
Onset 2-12 months
- weakness and ataxia
- skeletal muscle affected first

20
Q

Describe the pathology and clinical signs underlying Mannosidosis ?

A

Mannosidosis
(lysosomal storage disease)

Pathology
Deficiciency of B mannosidase
Storage of mannose rich oligosaccharides
- Murry grey and belted galloway cattle
- foamy change of neurons

Clinical signs
- ataxia
- tremors
- hypermetria (over-stepping).

21
Q

Identify this lysosomal storage disease and describe its pathology ?

A

Globoid cell Leukoodystrophy
(Lipid storage disease)

Defective galactocerebrosidase
Accumulate psychosin which is toxic to Schwann and Oligodendrocyte cells.

Lesions
White matter degeneration
- phagocytosis of myelin produces large macrophages (globoid cells)

22
Q

Identify this lysosomal storage disease ?

A

Ceroid Lipofuscinosis

23
Q

Describe the pathology and clinical signs of Ceroid Lipofuscinosis ?

A

Ceroid lipofuscinosis

Abnormal metabolism of lipopigments
- Border collies blue cattle dogs
- onset 1-2 years

Clinical signs
- rapid progression
- blindness and behavioural changes
- dullness, restlessness
- loss of learned behaviour

Lesions
Atrophy of cerebrum and cerebellum
- reduced number of neurons
- remaining neurons contain pigment

24
Q

What are the three main forces to cause CNS trauma ?

A

Forces which result in CNS trauma

  1. Compression (crushing)
  2. Tensile (stretching / pulling)
    1. Shearing (parallel to the surface)

Three main types of injury in the CNS
Concussion
Contusion
Laceration

25
Define a concussion
Concussion Often a diffuse brain injury with no gross lesions - causes temporary loss of consciousness with recovery - can also undergo temporary spinal concussion
26
Identify this lesion and describe its pathology ?
Contusion (more severe impact which results in haemorrhage). Pathology The causes of CNS haemorrhage 1. Trauma (most common) 2. Endothelial damage (septicaemia) 3. Coagulopathy ( anticoagulant rodenticide poisoning) 4. Vasculitis - Bovine malignant catarrhal fever - FIV - Equine Herpes virus 1 - Classical swine fever
27
28
Define a coup and countercuope injury ?
Coup Direct injury at the point of impact Countercoup Stretching / tearing of nerves and vessels on the opposite side as the point of impact
29
Describe the consequences of intracranial haemorrhage / contusion ?
30
Identify this CNS trauma ?
CNS trauma Laceration Distinct disruption of the tissue - fracture of the cranium or vertebral column - penetration of a shrp object (eg canine teeth
31
Identify this lesion and describe its pathology ?
Haematomyelia (haemorrhage of the spinal cord). Pathology - can be associated with disc herniation - can transect spinal cord - can extend cranially and caudally from original site of trauma
32
Identify this lesion and describe its pathology ?
Inveretebral disc herniation ? Pathology * Nucleus pulposus degeneration - loss of elasticity prevents even distribution of compressive loads * Degeneration of the anular ligament - sudden loading of vertebral column when felxed can cause so much pressure it ruptures.
33
Describe type one and two Intervertebral disc herniation ?
Invertebral disc herniation Type 1 Disc herniation Rupture of the annular ligament with fragments of nucleus pulposis present in the spinal canal - acute onset - Duchshund, beagle Type two disc herniation Protrusion of the spinal canal without rupture of the annular or dorsal longitudinal ligament - often chronic progressive onset - esp older larger breed dogs - age related fibrous degeneration of nucleus pulposis
34
Identify this lesion and describe its pathology ?
Cervical Stenotic Myelopathy (wobbler syndrome) There is two forms in horses; Static Absolute narrowing of the lumen of the spinal canal - - often 1-4 years - C5 to C7 Dynamic Narrowing only occurs during flexion of the neck. - often younger - 2 years - C3 - C5 Dogs Most at C5 - C7 except basset hounds C3 Dobbermans, great danes
35
Describe the gross lesions and histopathology of Wobbler syndrome ?
Cervical stenotic myelopathy (wobbler syndrome) Gross lesions - may be very subtle esp dynamic type - if slow development may see marked indentation of the cord Histopathology - slow development - may be mild lesions - degenerated neurons and axons removed Rapid onset Acute ischaemic necrosis of white or grey matter - Wallerian degeneration of axons cranially and caudally - Gitter cells
36
Identify this lesion and describe its pathology ?
Discospondylitis Inflammation of the spinal cord Pathology Brucella suis Aspergillus spp Arcanobacterium pyogenes
37
Provide a definition of Scoliosis and Kyphosis ?

TV3002 (13 decks)

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