Central Nervous System Flashcards
Enlargement of the entire ventricular system
Communicating hydrocephalus
Normal pressure hydrocephalus
Dilation of the ventricular system with a compensatory increas in CSF volume
Hydrocephalus Ex Vacuo
Dictates that any increase in volume of cranial constituents must be compensated by a decrease in volume of another
Monroe-Kellie Doctrine
Unilateral expansion of a cerebral hemisphere displaces the cingulate gyrus under the falx ceribiri leading to compression of the branches of the anterior cerebral artery
Subfalcine (cingulate) herniation
Medial temporal lobe compressed against free margin of tentorium leading to CNIII and posterior cerebral artery compression
Transtentorial herniation
Hemorrhagic lesions in midbrain and pons occurring during transtentorial herniation
Duret hemorrhages
Life-threatening herniation that causes brainstem compression which compromises vital respiratory and cardiac centers in the medulla oblongata
Tonsillar herniation
Neural tube defect with diverticulum of malformed tissue extending through a defect in the cranium
Encephalocele
Failure of closure of posterior neuropore causing asymptomatic bony defect or sever cord malformation with meningocele
Spina bifida (aka spinal dysraphism)
Extension of CNS tissue through a defect in the vertebral column
Myelomeningocele
Absence of the brain and calvarium. There is a flattt ned remnant of disorganized brain tissue (area cerbrovasculosa)
Anencephaly
Non-progressive neurologic deficit attributable to hypoxic insults during the prenatal and perinatal periods
Cerebral palsy
Cord malformation associated with Chiari I malformation
Syingobulbia
Formation of fluid-filled cleft-like cavity in the inner portion of the cord
Syringomyelia
Fluid-filled cavity that extends from cord to brainstem
Syringobulbia
Thinning out of gyri due to cortical ischemia
Ulegyria
Marbolization of deep nuclei due to ischemia & gliosis
Status marmoratus
Supratentorial periventricular white matter infarct with chalky yellow plaques
Perivetricular leukomalacia
Cystic infarcted lesions in the brain. Multiple cavities traversed by a web of delicate glial strands.
Multicystic encephalopathy
Acceleration-deceleration injury at the site of impact
Coup injury
Acceleration-deceleration injury opposite the site of impact
Countercoup injury
Parenchymal brain injury with pericapillary edema and extravasation
Contusions
Parenchymal brain injury, depressed retracted yellow brown patches involving the crests of gyri (placque jaune)
Old traumatic lesions
Wide asymmetric axonal swelling with gliosis and degeneration
Diffuse axonal injury
Arterial bleed which creates a blood-filled space between the bone and dura. Lenticular on CT-scan. Manifests wi lucid interval and rapid deterioration
Epidural hematoma
Fracture of the pterion will lead to severance of this artery
Middel meningeal artery
Venous bleeding between the dura and arachnoid membranes. Crescent-shaped on CT-scan. Delayed presentation with fluctuating levels of consciousness.
Subdural hematoma
Outcome of severe hypotensive episode. Poor demarcation between gray and white matter. Microvacuolization and eosinophilia with reactive gliosis
Global cerebral ischemia
Focal cerebral ischemia with r d neurons, reactive gliosis, and liquefactive necrosis
White infarct
Parallel white infarcts but with extravasation and resorption of blood found in focal cerebral ischemia
Red infarcts
Development if small cavitary infarcts which resemble lace-like spaces in hypertensive cerebrovascular disease
Lacunar infarct
Common site of lacunar infarct in hypertensive cerebrovascular diseases
Lenticular nucleus (putamen and globus pallidus)
Rupture of small-caliber penetrating vessels that leaves behind slitlike cavity
Slit hemorrhages
Necrosisin a band-like pattern, with a relative preservation of cells immediately adjacent to the meninges
Pseudolaminar necrosis
Characterizes hypertensive encephalopathy
Diffuse cerebral dysfunction Headache Confusion Vomiting Convulsions
Hypertensive CVD complication with preferential involvement of large areas of the subcortical whit matter with myelin and axon loss
Binswanger syndrome
Hypertensive CVD complication that causes dementia, gait abnormalities and pseudobulbar signs, often with superimposed neurologic deficits
Vascular dementia
The most common cause of spontaneous non-traumatic intraparenchymal hemorrhages
Hypertension
Minute aneurysms of the basal ganglia that develop in hypertension
Charcot-Bouchard microaneurysms
2nd most common cause of spontaneous non traumatic intraparenchymal hemorrhages
Cerebral amyloid angiopathy
Most frequent cause of clinically significant subarachnoid henorrhage
Intracranial aneurysms (most common type SACCULAR ANEURYSM)
Most common type of intracranial aneurysm
Saccular aneurysm
Yellowish CSF from ruptured intracranial aneurysm
Xanthochromia
Discrete lesions in the brain with liquefactive necrosis surrounded by fibrosis and swelling
Brain abscess
Manifestation of tertiary syphilis
Neurosyphilis
Etiology of syphilis
Treponema pallidum
Obliterative gelatinous of fibrinous exudate at the basal forebrain with well formed granulomas with caseous necrosis and giant cells
TB meningitis
Obstructive hydrocephalus with soap bubble appearance, gelatinous material within the subarachnoid space and small cysts
Cryptococcal meningitis
Brain abscess with central foci of necrosis surrounded by tachyzoites and bradyzoites. Ct-scan show ring enhancing lesions
Toxoplasmosis
Spongiform transformation of the cerebral cortex and deep gray matter
Creutzfelt Jakob Disease
Severe neuronal loss, reactive gliosis and cystlike expansionin CJD
Status spongiosus
Autoimmune demyelinating disorder with distinct episodes of neurologic deficits separated in time attributable to white matter lesions that are separated in space
Multiple sclerosis
Most common demyelinating disease
Multiple sclerosis
Most common presentation of multiple sclerosis
Optic neuritis
Most common cause of dementia
Alzheimer’s disease
Early onset dementia is found in patients with
Down syndrome
Found in alzheimers. Depletion of cholinergic neurons in __________
Nucleus basalis of meynert
Composed of tau protein found in alzheimers
Neurofibrillary tangles
Consists of paracrystalline arrays of beaded actin filaments
Hurano bodies
Composed of AB amyloid found in alzheimers
Neuritic (senile) plaques
Deterioration of language and changes in mood. Atrophy of frontal and temporal lobes.
Frontotemporal dementia
Early onset behavioral changes with wafer-thin gyri (knife-edge appearance) pick bodies
Pick disease
Pallor of substantia nigra, lewy bodies (a-synuclein)
Parkinson’s disease
Prototype trinucleotide repeat disease (CAG repeats)
Hintington disease
Presents with progressive movement disorders (chorea) and dementia. Atrophy of the caudate nucleus
Huntington disease
Loss of lower motor neurons in spinal cord and brainstem. Caused by mutation in SOD1 gene in chromosome 21
Amyotrophic lateral sclerosis
PAS-positive cytoplasmic inclusions found in ALS
Bunina bodies
Presents ieth psychitic symptoms reversible with thiamine administration
Wernicke encephalopathy
Presents with memory disturbance and confabulation which is prolonged and largely irreversible
Korsakoff syndrome
Pathologic finding of wernicke encephalopathy
Hemorrhages and necrosis of the mammillary bodies
Thiamine deficiency associated with hemosiderin laden macrophages in cystic spaces of the dorsomedian nucleus of the thalamus
Korsakoff syndrome
Common location of primary brain tumor in adults
Supratentorial (70%)
Common location of primary brain tumor in children
Infratentorial (70%)
Most common supratentorial primary brain tumor in adults
Glioblastoma multforme
Most common infratentorial primary brain tumor in children
Cystic cerebellar astrocytoma
70% of ALL neuroglial tumors usually involves frontal lobe in adults and cerebellum in children
Astrocyoma
A high grade astrocytoma with pseudo-palisading pattern of tumor cells
Glioblastoma multiforme
CNS tumor with loose microcystic pattern with bipolar cells and rosenthal fibers
Pilocytic astorcytoma
CNS tumor with cytoplasmic halos and perineural satellitosis
Oligodendriglioma
Benign CNS tumor derived from ependymal cells. Characterized by PERIVASCULAR PSEUDOROSETTES and is commonly located in the spinal cord
Ependymoma
CNS tumor with HOMER WRIGHT ROSETTES desmoplasia, and DROP METASTASES in the cauda equina
Medulloblastoma
The most common benign brain tumor in adults. Has PSAMMOMA BODIES.
Meningioma
The most common brain malignancy
Brain metastasis (lungs)
Lungs>breast>melanoma>kidney>GI
Most common site of Schwannomas
Cerebellopontine angle
Autosomal dominant metastatic brain tumor characterized by hamartomas (potato or tuber appearance) development of benign neoplasms involving the brain and other tissues.
Shagreen patches and ash-leaf patches
Tuberous sclerosis
Potato or tuber appearance and candle-guttering
Tuberous sclerosis
Only a portion of the ventricular system is enlarged because of excess CSF
Noncommunicating Hydrocephalus
