Unit 1b: Neuropathology

Question 1

Cerebral spinal fluid (CSF)

Answer 1

the fluid surrounding the brain and spinal cord that cushions the nervous system; fluid is similar to blood plasma

Question 2

Ventricle

Answer 2

CSF- filled cavities in the brain, four total (left, right, third, and fourth)

Question 3

Choroid plexus

Answer 3

The specialized cells lining the ventricles responsible for the creation of CSF

Question 4

Lumbar puncture

Answer 4

A method to withdraw CSF for testing from a low part of the column just below the spinal cord

Question 5

Arachnoid granulations

Answer 5

the bubble- like portions of the arachnoid mater (middle layer of meninges) into the draining venous sinus system that are responsible for the removal of CSF from around the brain; CSF is ‘recycled’ into the blood stream

Question 6

Hydrocephalus

Answer 6

(‘water on the brain’) disorder of CSF causing problems with CSF flow or reuptake; leads to head enlargement, developmental problems, changes in eye gaze, and, if left untreated, death; may be developmental or acquired; primarily treated with a shunt to siphon CSF away from the brain into the abdomen

Question 7

Hydrocephalus ex vacuo

Answer 7

large space develop inside cortex due to loss of cortical tissue - ‘cortical atrophy’; seen in dementia; NOT really hydrocephalus

Question 8

non-communicating hydrocephalus

Answer 8

hydrocephalus caused by a something obstructing the normal flow of CSF; CSF behind obstruction (between production in choroid plexus and obstruction) would increase in pressure; blockages can be from things like a tumor/mass or a clot of blood/infection

Question 9

communicating hydrocephalus

Answer 9

hydrocephalus caused by a problem with the normal uptake of CSF through arachnoid granulations; whole CSF system would have increased pressure

Question 10

Shunt

Answer 10

in brain disorders, a shunt is a tube placed inside the skull to drain off extra fluid, as seen in hydrocephalus (ventriculoperitoneal shunt) and strokes (intraventricular shunt)

Question 11

Blood vessels

Answer 11

the part of the circulatory system that transports blood throughout the human body. Three major types of blood vessels are the arteries, the capillaries, and the veins.

Question 12

Circle of Wilis

Answer 12

a circle of arteries that supply blood to the brain. This arrangement of blood vessels allows for collateral blood flow to the brain.

Question 13

Carotid artery

Answer 13

a blood vessel that supplies the head and neck with oxygenated blood. There are two carotid arteries, one on each side. They supply blood to the anterior part of the brain; carotid artery divides in the neck into the internal (supplies circle of Willis) and external (the artery you take a pulse from on the neck) carotid arteries

Question 14

Vertebral artery

Answer 14

a blood vessel that runs up the back of the neck. There are two vertebral arteries, one on each side, that join at the base of the skull to form the basilar artery. These vessels supply the posterior part of the brain.

Question 15

Basilar artery

Answer 15

the artery that supplies the pons, cerebellum, posterior cerebrum, and inner ear. This vessel is formed by the merging of the vertebral arteries.

Question 16

Middle cerebral artery

Answer 16

The artery that supplies lateral cerebral cortex
and anterior temporal lobes; strokes here can affect face, arm, and language use

Question 17

Anterior cerebral artery

Answer 17

The arteries that supply oxygen to most medial
portions of frontal lobes and superior medial parietal lobes; strokes here can affect leg use

Question 18

Stroke

Answer 18

rapid loss of brain tissue and function as a result of disruption of the blood supply to the brain

Question 19

Transient ischemic attack (TIA)

Answer 19

‘mini stroke’, same wide-range of possible
symptoms as a stroke, but symptoms are only temporary

Question 20

Ischemia

Answer 20

lack of oxygen arising from a restriction in blood supply

Question 21

Ischemic stroke

Answer 21

a stroke resulting from restriction of blood flow into a region of brain tissue

Question 22

Thrombus

Answer 22

a clot, or atherosclerotic plaque, that forms in place within a blood vessel obstructing blood flow. A thrombus can close off blood flow at the place it forms or may break apart to form an embolus.

Question 23

Embolus

Answer 23

a moving clot that then lodges in a small vessel

Question 24

Carotid stenosis

Answer 24

abnormal narrowing of the carotid artery, often caused by atherosclerotic plaque formation

Question 25

Hemorrhage

Answer 25

bleeding, the loss of blood from the circulatory system

Question 26

Hemorrhagic stroke

Answer 26

a stroke resulting from blood bleeding into the brain, damaging tissue

Question 27

Aneurysm

Answer 27

a localized, blood-filled bulge of a blood vessel

Question 28

Subarachnoid hemorrhage

Answer 28

bleeding that occurs between the arachnoid and the pial meningeal layers. The subarachnoid space is the space where the CSF flows around the brain and spinal cord, the space that is also filled with spider-web-like protrusions of the arachnoid mater.

Question 29

Intracerebral hemorrhage

Answer 29

bleeding that occurs within the brain tissue itself; this would be below the pia mater.

Question 30

Intraventricular hemorrhage

Answer 30

bleeding that occurs from vessels along the
ventricles; the bleeding in this case would be directed into the ventricles.

Question 31

tPA

Answer 31

drug made from tissue plasminogen activator, a protein involved in the breakdown of blood clots; used to treat ischemic stroke if within 3 hours of symptom onset

Question 32

Venous malformation

Answer 32

a general term for congenital vascular anomalies; the anomalies – unusual formations – can involve only veins or veins and arteries. Such malformations often increase the patient’s risk of bleeding in the brain and/or abnormal oxygen delivery to the brain tissue.

Question 33

Arteriovenous malformation (AVM)

Answer 33

a vascular malformation that is a tangle of abnormal blood vessels connecting arteries and veins in the brain; has increased risk of bleeding and decreases normal oxygen flow to local tissues (no capillary bed for gas exchange).

Question 34

Venous thrombosis

Answer 34

a blood clot that forms within a vein. In the brain, this may occur in the large venous sinuses and block off blood flow out of the brain, which frequently is fatal.

Question 35

Bridging veins

Answer 35

veins that drain the neural tissue and puncture (‘bridge’) through the dura mater to drain into the venous sinuses. They may tear with trauma and bleed to cause a subdural hematoma. Bridging veins have a higher risk of rupturing from trauma from a fall in patients who suffer from alcoholism. Long-term alcoholism both weakens the vein vessel walls throughout the body and shrinks the brain, which puts greater stress on the bridging veins specifically.

Question 36

Hematoma

Answer 36

a solid swelling of clotted blood within the tissues, which can be located anywhere in the body. A hematoma is also called a bruise when in/under the skin. In the brain, a hematoma causes local mass effects, such as compressing and injuring surrounding brain tissue like a brain tumor can.

Question 37

Subdural hematoma

Answer 37

bleeding that occurs below the dura – between the dura and the brain (or spinal cord), resulting in a build-up of blood that compresses the brain (or spinal cord). This type usually come from trauma, like a fall that tears the bridging veins. Compared to epidural hematomas, these usually have a slower onset, as lower-pressure venous blood is usually involved

Question 38

Epidural hematoma

Answer 38

bleeding that occurs between the skull and the dura (or spinal column and dura), resulting in a build-up of blood that compresses the brain (or spinal cord). This type usually develops from trauma, especially in conjunction with a skull fracture. Compared to subdural hematomas, these tend to have a faster (and, thus, more serious) onset, as higher-pressure arterial blood is usually involved.

Question 39

Traumatic brain injury (TBI)

Answer 39

damage to the brain as a result of external
physical force; common term = concussion

Question 40

Coup / contra-coup injury

Answer 40

results from focal injury or whiplash, in which the side of the brain directly hit and the opposite side are both damaged

Question 41

Diffuse shearing injury

Answer 41

rapid acceleration/deceleration forces separates cell bodies and axons, causing widespread brain injury

Question 42

Phineas Gage

Answer 42

A man who had a train spike shoot through his frontal cortex inan accident. He survived, but was emotionally disturbed from that point forward.

Question 43

Blood brain barrier

Answer 43

a filtering mechanism of the capillaries that carry blood to the brain and spinal cord tissue, blocking the passage of certain substances (i.e.,
infectious agents, immune cells, some drugs).

Question 44

Meningitis

Answer 44

Viral or bacterial infection of the meninges. Symptoms include rash, stiff neck, headache, vomiting, mental status change

Question 45

Encephalitis

Answer 45

Usually viral (herpes) infection of brain tissue. Symptoms include personality changes, seizures, weakness

Question 46

Measles

Answer 46

is a childhood infection caused by a virus. Once quite common, measles can now almost always be prevented with a vaccine. Measles symptoms appear 7 to 14 days after contact with the virus and typically include high fever,
cough, runny nose, and watery eyes. Measles rash appears 3 to 5 days after the first symptoms.

Question 47

Subacute sclerosing panencephalitis (SSPE)

Answer 47

SSPE is characterized by a history of primary measles infection, followed by an asymptomatic period that lasts 7 years on average, but can range from 1 month to 27 years. After the asymptomatic period, progressive neurological deterioration occurs, characterized by behavior change, intellectual problems, myoclonic seizures, blindness, ataxia, and eventually death.

Question 48

Rabies

Answer 48

Virus that enters the brain by following peripheral nerves, causing diffuse brain swelling. Symptoms include headaches, fever, rages, inability to swallow water, coma, and death.

Question 49

Prion

Answer 49

infectious protein molecules

Question 50

Creutzfeld-Jakob disease (CJD) / transmissible spongiform encephalopathy

Answer 50

commonly known as mad cow disease; prional infection kills off brain cells, creating numerous lacunae (‘lakes’) in the brain tissue. Symptoms include dementia and problems with coordination

Question 51

Encephalopathy

Answer 51

means disorder or disease of the brain. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of
global brain dysfunction; this syndrome can be caused by many different
illnesses.

Question 52

Cysticercosis

Answer 52

condition resulting from infection with the pork tapeworm. Symptoms include headache, stroke-like effects, brain swelling, risk of death.

Question 53

Brain tumor

Answer 53

any intracranial growth created by abnormal and uncontrolled cell division, normally either in the brain itself (e.g., neurons, glial cells, lymphatic tissue, blood vessels), in the cranial nerves (e.g., myelin-producing Schwann cells), in the brain envelopes (e.g., meninges), skull, pituitary and pineal gland, or spread from cancers primarily located in other organs (e.g., metastatic tumors). Any type of tumor in the brain can cause damage either through direct
damage to the surrounding tissue or through a mass effect – in which the pressure of the tumor squishes down parts of the brain

Question 54

Holoprosencephaly

Answer 54

a congenital disorder caused by the failure of the embryonic forebrain to sufficiently divide into the double lobes of the cerebral hemispheres. The result is a single-lobed frontal brain structure usually with severe skull and facial defects.

Question 55

Autism

Answer 55

Diffuse development disorder that impairs social interaction and communication

Question 56

Epilepsy

Answer 56

chronic neurological disorder that is characterized by recurring seizures

Question 57

Neurodegeneration

Answer 57

progressive loss of structure or function of neurons, including death of neurons

Question 58

Dementia

Answer 58

progressive decline in cognitive function due to damage or disease in the brain

Question 59

Atrophy

Answer 59

loss of cells

Question 60

Alzheimer’s disease

Answer 60

the most common form of dementia, characterized by loss of memory, cognitive abilities, and widespread neurodegeneration