What he said

Question 1

MC brain tumor in adults

Answer 1

METS

Question 2

What are red neurons?

Answer 2

dying neurons dt sustained hypoxia

• vacuolated
• eosinophilia of cytoplasm

Question 3

Red Neurons are seen in what dz?

Answer 3

cerebral infarction aka stroke

Question 4

MC cause of thrombotic occlusion in the brain? (this causes an ischemic stroke)

Answer 4

atherosclerosis

- of course, smoking is a risk factor

Question 5

What is the most malignant form of astrocytoma?

Answer 5

GBM, Glioblastoma Multiforme

- this is the worst dx of primary brain tumors

Question 6

Glioblastoma Histo

Answer 6

high cellularity, anaplasia, nuclear anaplasia…. increase in mitotic figures

Question 7

What brain lesion looks like a butterfly (S-shaped) that crosses the corpus

Answer 7

Glioblastoma Multiforme

Question 8

After 12-24 hrs of a stroke (cerebral infarct), what will the brain look like, grossly?

Answer 8

• “blurring of grey-white junction”

- also, discoloration, softening, edema

Question 9

MC brain tumor in children?

Answer 9

astrocytic tumors

• Glioblastoma!
• then, medulloblastoma, ependymoma, craniopharyngioma

Question 10

4 major classes of primary brain tumors:

Answer 10

1. meningioma
2. glioma
3. neuronal
4. poorly differentiated

Question 11

what are some gliomas?

Answer 11

astrocytoma, oligodendroglioma, ependymoma

Question 12

Ependymomas are usually located where?

Answer 12

• line the ventricles! of the brain

- but after 20 yo, more often found in spinal cord

Question 13

MC vessel affected in cerebral vascular stroke? (like thrombotic occlusion in ischemic stroke)

Answer 13

middle cerebral artery

- (this vessel comes off the carotid)

Question 14

Which is worse? Ischemic or Hemorrhagic stroke?

Answer 14

hemorrhagic (specifically intracerebral), but less common

Question 15

What is a berry aneurysm?

Answer 15

thin wall out-pouching in the circle of Willis

Question 16

Most common cause of subarachnoid hemorrhage?

Answer 16

rupture of a berry aneurysm

- remember that med student w the acute severe HA, then died

Question 17

MC type of vascular malformation in the brain that is clinically significant?

Answer 17

Arteriovenous malformations

Question 18

what type of hematoma of head usu dt trauma - blood from middle meningeal artery accumulates bet dura and skull

Answer 18

Epidural Hematoma

Question 19

What type of hematoma in the head occurs when bridging veins between the brain and superior sagittal sinus are damaged and usually occurs in the fronto-parietal region of the cerebrum?

Answer 19

sub-dural hematoma

• bet dura and arachnoid
• crescent shaped

Question 20

What types of hemorrhage do arteriovenous malformations cause?

Answer 20

intracerebral or subarachnoid

Question 21

MC cause of intracerebral hemorrhage?

Answer 21

HTN

vs. trauma

Question 22

Which brain tumor is the most common of the poorly differentiated (looks embryonal), usu in cerebellum, and 20% of all brain tumors of children?

Answer 22

Medulloblastoma

Question 23

tumor cells are small, ovoid, slightly elongated w high nuclear/cytoplasmic ratio

Answer 23

Medulloblastoma

Question 24

What the usually causes of cerebral infarction dt ischemia and hemorrhage?

Answer 24

• ischemic stroke is usu dt atherosclerosis

- hemorrhagic stroke is usu dt HTN

Question 25

Which is MC? ischemic stroke or hemorrhagic stroke?

Answer 25

ischemic stroke

Question 26

if you're suspicious of a stroke, what imaging to do?

Answer 26

CT first (blood is opaque), then MRI

Question 27

What is Central Pontine Myelinolysis?

Answer 27

usu iatrogenic - overly rapid correction of hyponatremia - demyelinating dz

Question 28

Cerebellar and brainstem stroke are usu dt problems with what arteries?

Answer 28

vertebral and basilar

Question 29

What is Hypertensive Encephalopathy?

Answer 29

Acute rise in BP causing an increase in intracranial pressure --> HA, confusion, V, convulsions, coma, death

Question 30

In children, 70% of brain tumors are located ____ the tentorium whereas in adults, 70% are found _____ the tentorium.

Answer 30

- below | - above

Question 31

What is a Basal skull fracture?

Answer 31

a type of linear skull fracture - petrus portion of temporal bone - leaks spinal fluid from ear

Question 32

MC skull fracture

Answer 32

Linear - dt severe head injury

Question 33

you will see Raccoon's eyes and/or Battle's sign in what kind of skull fracture?

Answer 33

Basilar skull fracture | Battle's sign - mastoid ecchymosis

Question 34

Epidural Hematoma assoc w damage to what artery?

Answer 34

MMA, Middle Meningeal Artery

Question 35

MC cause of Dementia

Answer 35

Alzheimer's Dz - death of nerve cells in brain - MC form is late-onset (>65 yo)

Question 36

Alzheimer's Dz, the MC cause of Dementia, is associated with what characteristic abN found in the brain?

Answer 36

Amyloid plaques (OUTSIDE) and Neurofibrillary tangles (INSIDE)

Question 37

MC form of Alzheimer's Dz

Answer 37

late-onset (vs early, familial)

Question 38

Vascular Dementia is also known as?

Answer 38

Multi-infarct Dementia, MID ---> low blood flow leading to damaged cells and loss of neuronal fx - cystic infarcts

Question 39

Vascular Dementia or MID imaging shows?

Answer 39

- cystic infarcts - increased ventricular size - diminished vol of grey and white matter

Question 40

What is Pick's Dz?

Answer 40

uncommon dementia affecting frontal and temporal lobes

Question 41

atrophy of brain looks "knife-like" is characteristic of what kind of dementia?

Answer 41

Pick's Dz

Question 42

What lobes are affected in Pick's Dz?

Answer 42

frontal, temporal

Question 43

What areas of the brain are affected in Parkinson's Dz?

Answer 43

pigmented | - substantia nigra, locus ceruleus

Question 44

Lewy Bodies are associated with?

Answer 44

Parkinson's with dementia - found within cytoplasm of neurons in the brain - a ddx for Alzheimer's

Question 45

What is the MC demyelinating Dz?

Answer 45

Multiple Sclerosis

Question 46

dt infx by JC virus?

Answer 46

Progressive Multifocal Leukoencephalopathy, PML, a demyelinating dz

Question 47

Are meningiomas usu malignant or benign?

Answer 47

- benign - adults - in arachnoid, attached to dura

Question 48

Are Gliomas usu malignant or benign?

Answer 48

they are malignant | - MC primary tumor the brain (astrocytoma)

Question 49

What is a TIA?

Answer 49

Transient Ischemic Attack - preceding an ischemic stroke dt complete occlusion of a cerebral vessel, TIA's or transient neurologic sxs are clinical markers for an increased risk of cerebral infarction

Question 50

What is the 3rd leading cause of death in the US?

Answer 50

stroke | - also the 3rd leading cause of major disability

Question 51

What is Gliosis?

Answer 51

reactive proliferation of astrocytes in response to damage of the CNS ---> can lead to a glial scar

Question 52

Macroscopic view of brain after cerebral infarct?

Answer 52

diffuse edema, narrowed sulci, widened gyri

Question 53

When will you see vacuolated neurons and eosinophilia of neuronal cytoplasm dt cerebral infarction?

Answer 53

first 12-24hrs after infarct

Question 54

When will you see infiltration of a cerebral infarct by neutrophils at edges of the lesion?

Answer 54

after ~24hrs

Question 55

When will you see increased # of m0 following a cerebral infarct?

Answer 55

1-14d