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Neurology Week 4 2018/19 > 4: Neuropathology 2 > Flashcards

4: Neuropathology 2 Flashcards

1
Q

Where is CSF produced?

A

Choroid plexuses of lateral, third and fourth ventricles

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2
Q

What is the other name for the cerebral aqueduct?

A

Aqueduct of Sylvius

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3
Q

Where is CSF reabsorbed?

A

Arachnoid granulations -> Sagittal sinus

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4
Q

What are three problems with CSF which can cause hydrocephalus?

A

Overproduction

Lack of absorption

Obstruction

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5
Q

What is

a) non-communicating
b) communicating

hydrocephalus?

A

a) Non-communicating - blockage within ventricles prevents CSF flow

b) Communicating - blockage elsewhere e.g subarachnoid space or granulations causes CSF blockage and hydrocephalus

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6
Q

What happens if hydrocephalus occurs before the skull bones have fused?

A

Head enlargement

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7
Q

An increase in CSF volume leads to an increase in ___ ___.

A

intracranial pressure

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8
Q

What happens to the brain in response to raised intracranial pressure?

A

Compression

then Herniation

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9
Q

Why is brain herniation so dangerous?

A

Compression of cranial nerves and centres

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10
Q

How is cerebral perfusion pressure calculated?

A

MAP - ICP

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11
Q

What are the symptoms of a raised ICP?

A

Headaches

N&V

Papilloedema

Neck stiffness

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12
Q

What are some examples of space occupying lesions?

A

Tumour

Abscess

Haematoma

Cerebral oedema

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13
Q

Why are the focal headaches associated with SOLs worse in the morning?

A

During sleep you become slightly hypercapnic

Which increases pressure

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14
Q

On which side of the tentorium cerebelli do brain tumours tend to arise in

a) adults
b) children?

A

a) above
b) below

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15
Q

Brain tumours most commonly found in the population are (primary / secondary).

A

Secondary

metastatic cancers from liver, breast, lungs…

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16
Q

Why are all brain tumours considered dangerous?

A

Compression effect

Even benign tumours grow slowly

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17
Q

What is the most common type of primary brain tumour in adults?

A

Astrocytoma (tumour of astrocytes, supporting cells)

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18
Q

Which grade of astrocytoma does not progress?

Who tends to get them?

A

Grade I

Children

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19
Q

Which grades of astrocytoma have the potential to become very malignant?

A

II, III and IV

20
Q

What is a Grade IV astrocytoma called?

A

Glioblastoma

21
Q

What is the 2nd most common primary brain tumour in children?

Where in the brain is it found?

A

Medulloblastoma

Cerebellum

22
Q

Medulloblastomas are (well / poorly) differentiated and have a (good / poor) prognosis.

A

poorly differentiated

poor prognosis

23
Q

What therapy is medulloblastoma susceptible to?

A

Radiotherapy

24
Q

What is an abscess?

A

Empty space filled with pus

25
Q

What are the symptoms of a brain abscess?

A

Fever

And raised ICP symptoms (headache, N&V, visual problems, neck stiffness)

26
Q

How are brain abscesses investigated and treated?

A

Brain imaging (CT / MRI)

Aspiration > Antibiotics

27
Q

What is meant by missile and non-missile trauma?

A

Missile - penetrating

Non-missile - blunt

28
Q

Penetrating head trauma tends to affect a ___ area.

A

focal area

29
Q

The greater the ___ of a projectile, the greater the size of the injury it causes.

A

velocity

30
Q

What happens to the head in a blunt force injury?

A

Sudden change in momentum

31
Q

The greater the ___ time of a blunt force injury, the smaller the force exerted on the brain.

A

contact time

32
Q

What happens to the brain within the skull in a blunt force injury?

A

Thrown around against cranial bones and protrusions

33
Q

What is the primary injury of head trauma?

Is it reversible or irreversible?

A

Initial damage to brain

irreversible

34
Q

What are some examples of secondary injury to brain trauma?

A

Haemorrhage

Oedema

Infection

Hypoxia

Raised ICP

35
Q

What are

a) linear
b) compound
c) depressed skull fractures?

A

a) Straight break
b) Involving scalp, open injury
c) Dents

36
Q

Skull fractures are very ___ ___ injuries.

A

high energy

37
Q

What is a coup-contracoup injury?

A

In terms of head injury:

coup - injury to brain on the side of its impact within the skull

contracoup - rebound injury on the opposite side of the skull

38
Q

Which impact tends to be worse in a coup-contracoup injury?

A

Contracoup

39
Q

What is diffuse axonal injury?

A

Shearing damage to neurons due to impact injury

40
Q

Diffuse axonal injury tends to affect ___ brain structures.

What are the symptoms?

A

midline

LOC, coma, vegetative state

41
Q

Which

a) neurotransmitter
b) ion

is released in response to acute brain injury?

A

a) Glutamate
b) Ca2+

also known as excitotoxicity

42
Q

What is a haematoma?

A

Collection of blood within the brain

43
Q

Most haematomas are found within the dura.

What does the swelling of a haematoma cause?

A

Raised ICP

Brain herniation

44
Q

Which artery may be disrupted by trauma to the area around the pterion?

A

Middle meningeal artery

45
Q

What type of injury occurs if the middle meningeal artery is damaged?

A

Extradural haemorrhage

46
Q

Subdural haematomas are more common in which group of patients?

A

Elderly

47
Q

Chronic Subdural haematomas are associated with ___ of the brain in elderly people.

A

atrophy

Neurology Week 4 2018/19 (12 decks)

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