Block 5 - Neurology

Question 1

Neurological pathologies?

Answer 1

Question 2

What is bottle X76-397?

Answer 2

• X76-397 Ruptured berry aneurysm I.C.A
• 2253 Brain: ruptured aneurysm with intracellular haemorrhage

Question 3

What is bottle TX2-M5470?

Answer 3

**TX2-M5470 Brain: Cerebral infarct
**
An acute cerebral infarct is seen here. Such infarcts are typically the result of arterial thrombosis or embolism. Interventions such as thrombolytic therapy with tPA to restore blood flow can help prevent or reduce permanent neurologic damage. However, therapies generally need to be administered within 6 hours from the time of stroke onset for greatest benefit.

Question 4

What is 707 Dura: Meningioma

Answer 4

**707 Dura: Meningioma
**
This circumscribed reddish-yellow firm neoplasm beneath the dura next to the falx is a meningioma. The superior parasagittal location is quite common.

Question 5

What is bottle 707?

Answer 5

**707 Dura: Meningioma
**
Note how this meningioma beneath the dura has compressed the underlying cerebral hemisphere. Rarely, meningiomas can be more aggressive and invade underlying cerebrum or overlying bone.

Question 6

What is bottle 2130?

Answer 6

**2130 Brain: Glioblastoma multiforme
**
Astrocytomas can range from low grade to high grade. Seen here is the highest grade and the worst possible form of glioma–a glioblastoma (previously glioblastoma multiforme). They occur in adults. Glioblastomas are quite vascular with prominent areas of necrosis and hemorrhage. Note how this large mass has crossed the midline to the opposite hemisphere.

Question 7

What is bottle 2129?

Answer 7

2129 Brain: carcinoma - metastatic
Seen here is a metastasis from a lung carcinoma. Metastases most often appear at the border of the grey and white matter in the distribution of the middle cerebral artery, as in this case, because that is where the blood flow (vascular distribution) is most likely to take metastases. Multiple tumor masses suggest a metastatic, not primary, malignant neoplasm

Question 8

363: Tumour (left renal bed):malignant schwannoma

Answer 8

363 - Tumour (left renal bed):malignant schwannoma

Question 9

What is bottle 406?

Answer 9

406
Tumour (left renal bed):malignant schwannoma

Question 9

What is bottle 406?

Answer 9

406
Tumour (left renal bed):malignant schwannoma

Question 10

What is bottle 421?

Answer 10

421
Mass right thigh: neurofibroma

Question 11

What is bottle 2261?

Answer 11

**2261 Brain: Acute purulent meningitis
**
The yellow-tan exudate of acute bacterial meningitis seen here obscures the sulci.
Note how the sulci are obscured by the exudate. A sample of cerebrospinal fluid (CSF) can be obtained via lumbar puncture, if there is no papilledema to indicate the intracranial pressure is too high to safely perform this procedure. The CSF in such cases typically has a low glucose, high protein, and a high cell count with many PMN’s. A gram stain should be done to aid in identification of bacterial organisms. The lactate dehydrogenase (LD) is increased with bacterial meningitis but not with viral meningitis.

Question 12

What is bottle A60-448?

Answer 12

**A60-448 Brain: Hydrocephalus probably of the communicating variety
**
Note the marked dilation of the cerebral ventricles. This is hydrocephalus. Hydrocephalus can be due to lack of absorption of CSF or due to an obstruction to flow of CSF.