Week 0: PATHOLOGY [part 1]

Question 1

occurs when the medial aspect of the temporal lobe is compressed against the free margin of the tentorium.

Answer 1

Transtentorial (uncinate, mesial temporal) Herniation

Question 2

When the extent of herniation is large
enough the contralateral cerebral peduncle may be compressed,
resulting in hemiparesis ipsilateral to the side
of the herniation; the compression in the peduncle in
this setting is known as the

Answer 2

Kernohan Notch

Question 3

Progression
of transtentorial herniation is often accompanied by secondary
hemorrhagic lesions in the midbrain and pons,
termed

Answer 3

Duret Hemorrhages

Question 4

accumulation of excess fluid within

the brain parenchyma.

Answer 4

Cerebral edema

Question 5

is an increase in

CSF volume within all or part of the ventricular system

Answer 5

Hydrocephalus

Question 6

severe malformation
with a flattened, disorganized segment of
spinal cord, associated with an overlying meningeal
outpouching.

Answer 6

Spinal dysraphism or spina bifida

Question 7

spinal dysraphism that is asymptomatic bony defect

Answer 7

spina bifida occulta

Question 8

extension
of CNS tissue through a defect in the vertebral
column

Answer 8

myelomeningocele

Question 9

applies when there is only

a meningeal extrusion

Answer 9

meningocele

Question 10

refers to a diverticulum of malformed

brain tissue extending through a defect in the cranium.

Answer 10

encephalocele

Question 11

overall recurrence rate for a neural tube defect

in subsequent pregnancies has been estimated at

Answer 11

4 to 5 percent

Question 12

malformation of the anterior end of the

neural tube, with absence of most of the brain and calvarium.

Answer 12

anencephaly

Question 13

flattened remnant of disorganized
brain tissue with admixed ependyma, choroid
plexus, and meningothelial cells

Answer 13

area cerebrovasculosa

Question 14

The absence of cortical gyri defines this abnormality,

Answer 14

lissencephaly

Question 15

characterized by small, unusually

numerous, irregularly formed cerebral convolutions.

Answer 15

polymicrogyria

Question 16

a spectrum of malformations characterized
by incomplete separation of the cerebral hemispheres
across the midline.

Answer 16

holoprosencephaly

Question 17

Holoprosencephaly is

associated with ____________ as well as other genetic syndromes.

Answer 17

trisomy 13

Question 18

absence of the white matter
bundles that carry cortical projections from one hemisphere
to the other

Answer 18

agenesis of the corpus callosum

Question 19

bat wing deformity on radiologic imaging

Answer 19

misshapen lateral ventricles d/t agenesis of the corpus callosum

Question 20

consists of a small posterior fossa, a misshapen midline
cerebellum with downward extension of vermis through
the foramen magnum (Fig. 28-7), and, almost invariably,
hydrocephalus and a lumbar myelomeningocele

Answer 20

Arnold-Chiari malformation (Chiari type II malformation)

Question 21

less severe disorder in
which low-lying cerebellar tonsils extend down into the
vertebral canal

Answer 21

Chiari type I malformation

Question 22

characterized by an enlarged
posterior fossa. The cerebellar vermis is absent or present
only in rudimentary form in its anterior portion

Answer 22

Dandy Walker Malformation

Question 23

hypoplasia
of the cerebellar vermis with apparent elongation
of the superior cerebellar peduncles and an altered
shape of the brainstem;

Answer 23

Joubert’s Syndrome

Question 24

Molar Tooth sign on imaging

Answer 24

Joubert’s syndrome

Question 25

characterized by expansion of the | ependyma-lined central canal of the cord

Answer 25

Hydromyelia

Question 26

formation of a fluid-filled cleft-like cavity in the | inner portion of the cord

Answer 26

Syringomyelia

Question 27

formation of a fluid-filled cleft-like cavity in the | inner portion of the cord that extends to the brainstem

Answer 27

Syringobulbia

Question 28

histologic appearance is destruction of the adjacent gray and white matter, surrounded by a dense feltwork of reactive gliosis

Answer 28

neurologic malformations in general

Question 29

Infarcts may occur in the supratentorial periventricular | white matter

Answer 29

perventricular leukomalacia

Question 30

The principal functional unit of the central nervous system | CNS

Answer 30

Neuron

Question 31

Neurons requires a continuous supply of ___ and _____ for its metabolic needs

Answer 31

glucose and oxygen

Question 32

spectrum of changes that accompany acute CNS hypoxia/ischemia or other acute insults and reflect the earliest morphologic markers of neuronal cell death (

Answer 32

acute neuronal injury/ red neurons

Question 33

morphologic patterns of red neurons

Answer 33

enlargement of the cell body, pyknosis of the nucleus, disappearance of the nucleolus, and loss of Nissl substance, with intense eosinophilia of the cytoplasm.

Question 34

axonal reaction to injury is manifested by

Answer 34

enlargement and rounding up of the cell body, peripheral displacement of the nucleus, enlargement of the nucleolus, and dispersion of Nissl substance from the center to the periphery of the cell (central chromatolysis).

Question 35

may occur as a manifestation of | aging, when there are intracytoplasmic accumulations complex lipids (lipofuscin), proteins, or carbs

Answer 35

neuronal inclusions

Question 36

Abnormal intranuclear inclusion seen in herpetic infection

Answer 36

Cowdry body

Question 37

Abnormal intranuclear inclusion seen in rabies infection

Answer 37

Negri body

Question 38

most important histopathologic indicator of | CNS injury, regardless of etiology

Answer 38

Gliosis

Question 39

These cells have multipolar, branching cytoplasmic pro cesses that emanate from the cell body and contain glial fibrillary acidic protein (GFAP),

Answer 39

Astrocytes

Question 40

they contribute to barrier functions controlling the flow of macro molecules between the blood, the cerebrospinal fluid (CSF) and the brain

Answer 40

Astrocytes

Question 41

are thick, elongated, brightly eosinophilic, irregular structures that occur within astrocytic processes, and contain two heat-shock proteins (αB-crystallin and hsp27) as well as ubiquitin

Answer 41

Rosenthal fibers

Question 42

are mesoderm-derived phagocytic cells that | serve as the resident macrophages of the CNS.

Answer 42

Microglia

Question 43

the ciliated columnar epithelial cells | lining the ventricles

Answer 43

ependymal cells

Question 44

an increase in intracellular fluid secondary to neuronal, glial, or endothelial cell membrane injury, as might be encountered in someone with a generalized hypoxic/ischemic insult or with a metabolic derangement that prevents maintenance of the normal membrane ionic gradient

Answer 44

Cytotoxic edema

Question 45

occurs especially around the lateral ventricles when an increase in intravascular pressure causes an abnormal flow of fluid from the intraventricular CSF across the ependymal lining to the periventricular white matter.

Answer 45

Interstitial Edema (hydrocephalic edema)

Question 46

if the ventricular system is obstructed and does not communicate with the subarachnoid space, as may occur because of a mass in the third ventricle, it is called

Answer 46

non communicating or obstructive hydrocephalus

Question 47

ventricular system is in communication with the subarachnoid space, and there is enlargement of the entire ventricular system.

Answer 47

Communicating Hydrocephalus

Question 48

compensatory increase in ventricular | volume secondary to a loss of brain parenchyma.

Answer 48

Hydrocephalus ex vacuo

Question 49

Displacement of brain tissue past rigid dural folds (the falx and tentorium) or through openings in the skull because of increased intracranial pressure

Answer 49

Herniation

Question 50

occurs when unilateral or assymetric expansion of a cerebral hemisphere displaces the cingulate gyrus under the falx

Answer 50

Subfalcine (cingulate) herniation