ch 28 s/s Flashcards
lots of CNS excitability that makes even the slightest touches very painful that can lead to involuntary motor contractions or convulsions
rabies
gyri look like a knife edge
Pick disease: a subset of FTLD-tau
False localizing signs (CN palsies
increased intracranial pressure
-brain abcess
cause intractable nausea, confusion, convulsions, and rapid onset of coma and then death
v high levels radiation
memory changes
Alzheimers dis
molar tooth sign
Joubert syndrome
LNs, thymus, and gonads are hypoplastic
Ataxia-telangiectasia
low grade tumor arising form pineocytes
Pineocytomas
Pick bodies and lobar restriction
Pick disease: a subset of FTLD-tau
status marmoratus
perinatal ischemic lesions of the cerebral cortex
-abnormal myelinization that gives rise to a marble-like appearance of the deep nuclei
Rapid quadriplegia death of locked in syndrome
Central pontine myelinolysis
inflammation of white and grey matter with neurofibrillary tangles
Subacute panencephalitis (SSPE)
focal, paraventrivular cystic changes and mild symmetric hydrocephalus
cystic fibrosis
significant ependymal injury
from CMV
perivascular accumulation of lymphocytes
Arthropod borne viral encephalitis
Meningeal vessels are engorged and prominent
meningitis
granulomas
TB of CNS
in ppl who develop a coma after trauma
Diffuse axonal injury
circumscribed, depressed, glassy, grey-tan, irregularly shaped plaques that are firmer than the surrounding brain
Multiple sclerosis (MS)
neoplasm w brightly eosinophilc cell body from which there are lots of stout processes that come out
Gemistocytic astrocytoma (type of type III infiltrating astrocytoma)
hydeocephalus ex vacuo
Alzheimers Dis
-ventricular widening d/t cortical atrophy
very long chain fatty acids (VLCFAs) in the serum
Adrenoleukodystrophy
microglial nodules
Arthropod borne viral encephalitis
-Microglial cells that form small aggregates around the foci of necrosis
painful radiculoneuritis
Cytomegalovirus
-when attack the lower spinal cord and roots
Neutrophils around the leptomeningeal vessels
less severe meningitis
blindness
Neuronal storage dzs: Ceroid lipocuscinoses
prbs in short term memory and confabulation
Korsakoff syndrome (development form Wernicke encephalopathy (Thiamine (vit B1) deficiency))
compression of ACA
subfalcine herniation
Asymmetric atrophy of the frontal and temporal lobes that spares the posterior 2/3 of the superior temporal gyrus
Pick disease: a subset of FTLD-tau
immunodeficiency
Ataxia-telangiectasia
midline cyst that is lined by ependymal
Dandy-walker malformation
wright rosettes
medulloblastoma
-neuronal granules
URIs
ALS
neuritic (senile) plaques
Alzheimers Dis
distal limb amyotrophy
Spinal and bulbar muscular atrophy (Kennedy dz)
Pseudo-palisading
Glioblastoma (type IV infiltrating astrocytoma)
-tumor cells collect along the edges of the necrotic regions
pnemonias
ALS
degeneration of the involved fiber tracts.
Diffuse axonal injury
Tuft of hair, dimple, outpouch
spina bifida occulta
Fever
- Subdural empyema
- rabies
nuclear atypia
Pleomorphic xanthoastrocytoma
Seizures
- increased intracranial pressure
- -brain abcess
- Arthropod borne viral encephalitis
- Subacute panencephalitis (SSPE)
- cerebral malaria
- Neuronal storage dzs: Ceroid lipocuscinoses
- Myoclonic epilepsy and ragged red fibers (MERRF)
- Leigh synd
- Gangliogliomas (but no more when removed)
- Dysembryoplastic neuroepithelial tumor
tumor that leads to widespread microscopic infarcts that result in nonlocalizing neuro symptoms like dementia
=Intravascular lymphoma
Anterior roots (pic) of the spinal cord are thin from loss of LMN fibers, loss of anterior horn neurons and reactive gliosis
ALS
demyelination in a subcortical location that has a center filled with lipid laden Mfs and a reduced number of axons
Progressive multifocal leukoencephalopathy (PML)
scattered lymphocytes
Acute necrotizing hemorrhagic encephalomyelitis
lose the ability to control all voluntary mvmt, but bladder and bowel sphincter and eye m’s are usu spared until the late course
ALS
fluid filled cavity in the inner portion of the cord
syrinx
cerebral gummas in meninges and parenchyma
Meningovascular neurosyphilis
-plasma cell rich mass lesions
dystonia
Cerebral palsy
cramping/spasticity of the arms and legs
ALS
dysarthric Speech
Ataxia-telangiectasia
Cowdry type A viral inclusion bodies in neurons and glia
Herpes simplex virus type I (HSV-1) encephalitis
pupillary dilation
transtentorial herniation
s/s that deal with cerebellum, brainstem, spinal cord, and peripheral nerves.
Huntingtons Ds
Change in pupil rxn
increased intracranial pressure
-brain abcess
dystrophic neurites that surround a central amyloid core
-There may also be a clear halo around all of this
plaques of Alzheimers Dis
gynecomastia
Spinal and bulbar muscular atrophy (Kennedy dz)
muscle strength and bulk decreases and fasciculations
ALS
disequilibrium with frequent falls
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
truncal ataxia, unsteady gait, and nystagmus
Wernicke –Korsakoff synd from toxic disorder from ethanol
-atrophy and loss of granule cells in the anterior vermis
muscle involvement with weakness and lactic acidosis
- Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS)
- Leigh synd
disseminated necrosis of white and grey matter with acute hem, fibrin deposition, and lots of neutrophils
Acute necrotizing hemorrhagic encephalomyelitis
tumor of temporal lobe with a cystic component
Gangliogliomas (type of neuronal tumor)
lensatic/lenticular bleed
Epidural (extra-) hematoma
central necrosis w new leaky (edema) bv surrounding it
brain abcess: new
testicular atrophy
Spinal and bulbar muscular atrophy (Kennedy dz)
enlarged oligodendrocyte nuclei w glassy amphophilic viral inclusions at the edges of the lesions
Progressive multifocal leukoencephalopathy (PML)
severely involves the inferior and medial regions of temporal lobes (arrows) and orbital gyri (asteric)
Herpes simplex virus type I (HSV-1) encephalitis
ventriculitis from pus into ventricles
fulminant meningitis
Tau-containing bundles of filaments in the cytoplasm that surround the nucleus of the neurons
- tangles of Alzheimers Dis
- Frontotemporal lobar degen (FTLD)-tau
- PArkinsons dis w LRRK2 mutation
- Progressive Supranuclear palsy
- corticobasal degeneration
angioinvasive –> can cause infarct in brains
vasculitis from mucormycosis and aspergillosis (fungal) meningoencephalitis
Solid, sometimes calcified, slow growing nodules attached to the ventricular lining and protruding into the ventricle
Subependymomas
-can cause hydrocephalus
greyish decoloration around vessels in the white matter
Acute disseminated encephalomyelitis (ADE)
symmetric loss of myelin in the basis pontis and the pontine tegmentum
Central pontine myelinolysis
festinating gait
Parkinsons dis
-(progressively shortened and accelerated steps)
Petechiae and fibrinoid necrosis of arterioles in the grey and white matter
HTN encephalopathy
more behavioral changes and the neuro symptoms progressed more slowly
Variant CJD (vCJD)
quick onset of altered neurological dysfunction including loss of consciousness, temp respiratory arrest, and loss of reflexes.
-Recovery is typically complete
parenchymal injury: concussion
chronic inflamm rxn
HIV
Brains are atrophic, enlarged ventricles, increased amounts of tau-containing neurofibrillary tangles
Chronic traumatic encephalopathy (CTE
sheared MMA
Epidural (extra-) hematoma
Duret hemorrhages:
transtentorial herniation
-hemorrhagic lesions in the midbrain and pons.
initial slight symmetrical numbness and tingling
Vit B12 deficiency
lose consciousness immediately
Epidural (extra-) hematoma
recurrent strokes (usually infarcts) and dementia
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)
Distended, loosely organized vascular channels arranged back to back with collagenized walls of variable thickness
Cavernous malformations
Precentral motor gyrus is atrophied
ALS
Spheroids
- Acute neuronal injury: when posttraumatic diffuse axonal damage (shearing of the axons)
- diffuse axonal injury
retardation
Agenesis of the corpus collosum
first decade of life with gait ataxia, then hand clumsiness and dysarthria, depressed/absent DTRs, impaired proprioception/vibration, sometimes loss of pain/temp/light touch
Friedreich ataxia
hematoma that occurs a fracture that crosses the line of a vessel
Epidural (extra-) hematoma
polycythemia
Von Hippel-Lindau ds
pes cavus
Friedreich ataxia
hemangioblastomas of the CNS (esp cerebellum and retina) and cysts of the pancreas, liver, and kidneys.
Von Hippel-Lindau ds
basal distribution of exudate
meningitis from H influ
osmotic demyelination disorder
Central pontine myelinolysis
Exudate on the leptomeninges
meningitis
Big grpings of gyral malformations
Pachygryria
status spongiosus
Creutzfeldt-Jackob Dz (CJD
-expansion of the vacuolated areas into cystlike spaces
dehydration that leads to confusion, stupor, and coma
hyperglycemia
pigmented nodules of the iris (lisch nodules)
NF1
alternating periods of mania and stupor
rabies
telangiectasias in the the CNS, conjunctiva, and skin of face/neck/arms
Ataxia-telangiectasia
Neutrophils fill the subarachnoid space
severe meningitis
subtle changes in memory and behavior, followed by rapid dementia and startle myoclonus
Creutzfeldt-Jackob Dz (CJD
agyria
lissencephaly
etat crible
lacunar infarcts
-w widening of perivasc spaces w/o tissue infarction
weakness
-Friedreich ataxia
reticulin deposits
Pleomorphic xanthoastrocytoma
episodes of neuro deficits separated in time
Multiple sclerosis (MS)
b/l cortical atrophy
Alzheimers Dis
mild progressive dementia
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
later: central areas cystic and gliotic
spinal cord injury
lesions have giant astrocytes with one to many irregular hyperchromatic nuclei
Progressive multifocal leukoencephalopathy (PML)
damage to the dorsal sensory roots –> poor proprioception and locomotor ataxia
Tabes dorsalis
Damaged basal ganglia and thalamus with patchy neuronal loss and reactive gliosis
perinatal ischemic lesions of the cerebral cortex
extensive cortical plaques that are surrounded by a halo of spongiform change
Variant CJD (vCJD)
many meningiomas
NF2
meningitis
HSV 2 encph
glomeruloid body
Glioblastoma (type IV infiltrating astrocytoma)
-vascular prolif –> tufts of cells to pile up and bulge into lumen–>forms a ball
B/l schwannomas of the vestibulocochlear nerves
NF2
Leptomeningeal fibrosis
pyogenic meningitis
Prbs with deglutition and phonation
bulbar ALS
globoid cells
krabbe dis
-aggregations of engorged Mfs
dementia
- HIV (from microglial inflamm)
- Alzheimers
- Parkinsons dis LATER
- Huntington Ds (start as forgetfulness)
- ALS maybe
Polymicrogyria
Arnold-chiari malformation type II
Failure of midline structures to form
Holoprosencephaly
build up of sulfatides in cytoplasmic vacuoles
Adrenoleukodystrophy
Ammonia and inflammatory cytokine levels are increased
Hepatic encph
Motor and sensory deficits of the extremities
Ischemia in the vertebrobasilar area
gelantinous material within the subarachnoid space
crytococcal (fungal) meningitis
rapidly progressive dementia
prion dis
asymm Axonal swelling and focal hemorrhagic lesions
Diffuse axonal injury
fluctuating course, hallucinations, and frontal signs
Parkinsons dis: dementia w lewy bodies
weakness, lethargy, ataxia, and seizures that takes 4-6 weeks to resolve
Herpes simplex virus type I (HSV-1) encephalitis
increased numbers of microglia
Diffuse axonal injury
hem is resorbed and leaves small slit like cavity that is surrounded by a brownish discoloration
slit hems
cardiomyophathy (pericardial adhesions, fibers are destructed w inflamm and fibrosis)–>arrhythmias and CHF –> most of the deaths
Friedreich ataxia
Dilated fundus and tortuous bvs
increased intracranial pressure
-brain abcess
small and empty microscopic vaculues within the neuropil
Creutzfeldt-Jackob Dz (CJD
well circumscribed tumor w calcifications
oligodendroglioma
autonomic disturbances
- Fatal familial insomnia (FFI)
- Parkinsons dis LATER
- Multiple system atrophy (MSA) (HoTN)
hx of seizures
- Pleomorphic xanthoastrocytoma
- oligodendroglioma (and other neuro complaints)
perivenular cuffs of lymphocytes and monocytes
active plaques of MS
4 or more mitoses per 10 high powered fields
Atypical meningiomas
overproducing CSF that leads to hydrocephalus
Choroid plexus papillomas (type of ependymoma)
mental confusion,
- subdural hematoma
- TB of CNS
- -Arthropod borne viral encephalitis
small gyri
microcephaly
photophobia
meningitis
impairment of EOMs
transtentorial herniation
apparent elongation of the superior cerebellar peduncles
Joubert syndrome
collagenous capsule surrounded by reactive gliosis (gemistocytic astrocytes)
brain abcess: old
raccoon eyes
basal skull fracture
lewy body that contains α-syn
Parkinsons dis
lumbar myelomeningocele
Arnold-chiari malformation type II
limb spasticity
Subacute panencephalitis (SSPE)
slowly progressive neurological deterioration, but sometimes there is acute decompensation
subdural hematoma
recurring infections
ALS
reduced cerebral blood flow
cerebral malaria
nausea/vomit
increased intracranial pressure
- brain abcess
- TB of CNS
Foaming of the mouth
rabies
-from contracture of the pharyngeal muscles
delirium
Arthropod borne viral encephalitis
death from resp failure
rabies
neural tissue and meninges that protrude through the vertebral defec
Myelomeningocele (or meningomyelocele)
headaches, nausea, vomiting, and papilledema
Delayed effects of radiation
Altered consciousness
Ischemia in the vertebrobasilar area
obliterative endarteritis
- TB of CNS
- Meningovascular neurosyphilis
paraplegia (if there is not prompt treatment)
Vit B12 deficiency
cyclopia
Holoprosencephaly
oligospermia
Spinal and bulbar muscular atrophy (Kennedy dz)
mononuclear cell perivascular cuffs
Poliomyelitis
Papilledema
increased intracranial pressure
- most important
- brain abcess
gliomas of the optic nerve
NF1
Acute: Hem, necrosis, axonal swelling
spinal cord injury
arrest of psychomotor dev
Leigh synd
choroid plexitis
Cytomegalovirus
change in personality
Alzheimers dis
Neurofibromas of the peripheral nerve
NF1
Rapidly progressive motor signs of stiffness and weakness that appears between 3-6m of life
krabbe dis
focal tissue destruction, pigment laden Mfs, and gliosis
slit hems
Acute lesions exhibit central necrosis, petechial hem surrounded by acute and chronic inflammation, Mf infiltration, and vascular proliferation
Cerebral toxoplasmosis
psychotic symptoms
Wernicke encephalopathy (Thiamine (vit B1) deficiency)
sleep prbs
-Fatal familial insomnia (FFI)
depigmentation of substantial nigra
chronic traumatic encephalopathy
reflex symmetry
- Acute aseptic viral meningitis
- Arthropod borne viral encephalitis
Central chromatolysis
Acute neuronal injury
tau in frontal and temporal lobes
FTLD-tau
stooped posture
Parkinsons dis
fluid filled cavity in the inner portion of the cord that can extend into the brainstem
syringobulbi
motor/sensory prbs
MS
cystic space with hemosiderin Mfs
Wernicke encephalopathy (Thiamine (vit B1) deficiency)
paresis
Cerebral palsy
worst ever sudden headache (and prob loose consciousness)
rupture of a sacular aneurism
atrophy and fasciculations of the tongue and the dysphagia
Spinal and bulbar muscular atrophy (Kennedy dz)
Hypoplasia of the cerebellar vermis
Joubert syndrome
areas above and below the injury show wallerian degeneration
spinal cord injury
behavioral changes and adrenal insufficiency.
Adrenoleukodystrophy
amphicytes
Ataxia-telangiectasia
-enlargement of the nucleus in many cells: schwann cells, endothelial cells, and pituicytes
Microglial nodules
HIV, rickettsia, other viruses
spasticity
MS
ulegyria
perinatal ischemic lesions of the cerebral cortex
-Thinned out gliotic gyri
sinopulmonary infections
Ataxia-telangiectasia
candle-guttering.
Tuberous sclerosis complex
-Large astrocyte-like cells will cluster beneath the ventricular surface
if exposed to MPTP
–> destroys substantia nigra –>Parkinsons dis
Alzheimer type 2 astrocyte
seen in ppl w long-standing hyperammonemia d/t chronic liver dis, Wilson dis, or hereditary metabolic disorders of the urea cycle
necrotizing ventriculoencephalitis
Cytomegalovirus
change in judgement
Alzheimers dis
when the bridging veins in the subdural space rupture
Subdural hematoma
tumor that grows grow en plaque
meningiomas
-tumor spreads in a sheetlike fashion along the dura
Visual field defects
Ischemia in the vertebrobasilar area
seizure ds, intracerebral hem, or subarachnoid hem
vascular malformations
bladder control prbs
MS
bradykinesia
Huntingtons Ds LATER
axonal swelling
HIV
cytoplasmic inclusions of α-syn in oligodendrocytes
Multiple system atrophy (MSA)
-(more sensative to oxidative stress)
Headache
- increased intracranial pressure(most important)
- subdural hematoma
- meningitis
- brain abcess
- Subdural empyema
- TB of CNS
- rabies
- Acute disseminated encephalomyelitis (ADE)
of GFAP positive astrocytic processes to make a fibrillary background appearance
- Diffuse astrocytoma (type II infiltrating astrocytoma)
- Pilocytic astrocytoma
- Ependymoma
- medullobalstoma***
cerebritis
fulminant meningitis
- inflammatory cells infiltrate the walls of the leptomeningeal veins and can travel down into the brain
apraxias
Corticobasal degeneration
-impaired higher cortical fct
sarcomas, gliomas, and meningiomas
yrs after radiation exposure
tumor that only appears in the cerebellum
medulloblastoma
vascular dysfunction –> Rapidly progressing encph
cerebral malaria
Burina bodies
ALS
-PAS positive cytoplasmic inclusions
flaccid paralysis –> muscle wasting and hyporeflexia of the affected area–>paresis or paralysis
Poliomyelitis
-can affect diaphragm
Multi-infarct dementia
HTN encephalopathy
compression of resp and cardiac ctrs of brain
Tonsillar herniation
T-cell leukemia
Ataxia-telangiectasia
Cerebellar tonsils extend down into the vertebral canal
Chiari type I malformation
tumor of superficial temporal lobe with attenuation of the overlying skull
Dysembryoplastic neuroepithelial tumor (type of neuronal tumor)
cerebellar vermis is absent or barely there
Dandy-walker malformation
cutaneous hyperpigmented spots (café au lait spots
NF1
inflammation that is most severe in the brainstem
rabies
perikaryon of neurons
Creutzfeldt-Jackob Dz (CJD
Meningitis associated septicemia with hem infarction of the adrenal glands and cutaneous petechiae
Waterhouse-friderichsen synd
lethargy
increased intracranial pressure
- brain abcess
- Acute disseminated encephalomyelitis (ADE)
hirano bodies
Alzheimers Dis
astrocytes that are sometimes filled with lipid
Pleomorphic xanthoastrocytoma
tangled vessels that are enlarged with lots of flow and pulsatile
Arteriovenous malformations (AVM)
rigid vessels, but no fibrosis
cerebral amyloid angiopathy (
-amyloid causes the rigidity
dialted lateral and 3rd ventricles
Huntingtons Ds
hydrocephalus
- Arnold-chiari malformation type II
- TB in CNS
- ependymomas if in posterior fossa
- medullobalstomas if they grow quickly
exudate over cerebral convexities over the sagittal sinus
meningitis from pnemonia
of chalky yellow plaques consisting of discrete regions of white matter necrosis and calcification
Periventricular leukamalacia
feeding prbs
Leigh synd
a neural tube defect that you must worry about infection
- Myelomeningocele (or meningomyelocele)
- meningocele
Battle’s sign
basal skull fracture
– reflecting orbital and mastoid hematomas
Cysticerososis
can cause non-communicating hydrocephalus
ataxia/athetosis
Cerebral palsy
pseudobulbar palsy
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
bipolar with cystic and fibrillary areas in the same tumo
Pilocytic astrocytoma
facial n. palsies
Neuroborreliosis
basal leptomeninges: they are thickened and opaque obstruct the outflow of CSF form the foramina of luschka and magendie hydrocephalus
crytococcal (fungal) meningitis
tumor that affects the japanese
Primary germ cell tumors
degeneration of ascending and descending spinal tracts from a defect in myelin formation
Vit B12 deficiency
kuru plaques
Creutzfeldt-Jackob Dz (CJD
-extracellular deposits of aggregated protein, congo red and PAS positive that typically occur in the cerebellum (cerebral cortex for vCJD)
dystrophic mineralization and adjacent gliosis
exposure of methotrexate at the same time as radiation
eye movement prbs.
Ataxia-telangiectasia
tumor w anastamosing caps
oligodendroglioma
amyloid core can be stained with congo red
plaques of Alzheimers Dis
impaired upward gaze
increased intracranial pressure
-brain abcess
psammoma bodies.
meningiomas
cerebral dysfunction including headaches, confusion, vomiting, convulsions, and sometimes coma
HTN encephalopathy
Vertigo
Ischemia in the vertebrobasilar area
jerking of limbs
Corticobasal degeneration
-asymm motor disturbances
enlarged posterior fossa
Dandy-walker malformation
know as Pick bodies
FTLD-tau
-smooth contoured inclusions
ragged red fibers in the muscle
Myoclonic epilepsy and ragged red fibers (MERRF)
a’s in CNS have thickening of media and adventitia (filled w protein) but no sm
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL)
urinary inontinence, slow dementia, giat disturbance
Nml pressure hydrocephalus
patches of irregular, ill-defines white matter injury
Progressive multifocal leukoencephalopathy (PML)
spasticity
- Cerebral palsy
- Friedreich ataxia
tau in hippocampus, entorhinal cortex, amygdala
Alzheimers dis
masked facies
Parkinsons dis
-diminished facial expression
ophthalmoplegia
Wernicke encephalopathy (Thiamine (vit B1) deficiency)
Can lead to CHF do to shunt effects if a newborn is affected
vascular malformations
Ocular palsy
- Acute aseptic viral meningitis
- Arthropod borne viral encephalitis
necrotizing vasculitis with focal hem
Arthropod borne viral encephalitis
Lightning pains and loss of DTRs
Tabes dorsalis
Mood, memory, and behavior prbs
Herpes simplex virus type I (HSV-1) encephalitis
mycobac avium-intracellulare
TB of CNS in AIDS pts
– lesions that contain confluent sheets of mfs filled w organisms, w few or no granulomas
when vascualr dementia preferentially involves large areas of the subcortical white matter with myelin and axon loss
Binswanger dz
Small, numerous, irregularly formed cerebral convolutions
Polymicrogyria
Plaques next to the lateral ventricles, optic nerves/chiasm, ascending/descending tracts, sc and brainstem
Multiple sclerosis (MS)
altered shape of the brainstem
Joubert syndrome
kernohan notch
transtentorial herniation
pallor of the substantia nigra and locus ceruleus
Parkinsons dis
change in language and math skills
Alzheimers dis (after mem)
Symmetrically dilated ventricles
Communicating hydrocephalus
stupor/coma
Arthropod borne viral encephalitis
- cerebral malaria
- Fatal familial insomnia (FFI)
- Acute disseminated encephalomyelitis (ADE)
neck stiffness
- meningitis
- Subdural empyema
malaise
- TB of CNS
- rabies
magnetic gait
Nml pressure hydrocephalus
bat wing deformity where the lateral ventricles are misshapen
Agenesis of the corpus collosum
tumor attached to the dura
meningiomas
death from resp failure
rabies
internuclear ophthalmoplegia
MS
collections of neurons in wrong locations
Neural heterotopias
nuchal dystonia
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
perivascular pseudorosettes
Ependymoma
-tumor is around the vessel with ependymal processes directed toward the wall
dropping objects and prbs with fine motor tasks
ALS early
-asymmetric weakness of the hands
Meningeal irritation
- meningitis
- rabies
resp m’s weakened
ALS
trouble walking, speaking, or understanding, as well as paralysis or numbness of the face, arm, or leg
stroke (cerebrovasc dis)
high grade tumor arising from pineocytes
Pineoblastomas
neuronal achromasia
Corticobasal degeneration
Dementia, gait prbs, pseudobulbar signs, and other focal neurological deficits
Vascular dementia
strokes w reversible damage
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS)
aseptic meningitis
- Neuroborreliosis
- HIV
change in visuospatial orientation
Alzheimers dis
metabolic prbs in those tissues affected
Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS)
Jerky, hyperkinetic, sometimes dystonic movements involving all parts of the body (chorea)
Huntingtons Ds
Tumor found within the ventricular system (esp lateral or 3rd)
Central neurocytoma
Tuberculomas
TB of CNS
CN s/s
MS
seizures, autism, and mental retardation
Tuberous sclerosis complex
osteomyelitis
Extradural abscess
giant cells
- TB of CNS
- HIV
disturbances of higher cortical fct and consciousness, w/o localizing signs
Fat emboli can happen after a bone fx causing CVD
cognitive decline
Subacute panencephalitis (SSPE)
red neurons
Acute neuronal injury: n death from depletion of glucose, O2, or trauma
Non-neoplastic enlarging cyst that grows on the roof of the 3rd ventricle where it can obstruct the foramina of monro to create non-communicating hydrocephalus
Colloid cyst of the 3rd ventricle(type of ependymoma)
Degeneration of LMNs
- Spinal and bulbar muscular atrophy (Kennedy dz)
- Spinal muscular atrophy (SMA)
compression of PCA
transtentorial herniation
–>ischemia of visal cortex
granulomatous arteritis
Varicella-zoster virus
Ataxia
- Ischemia in the vertebrobasilar area
- increased intracranial pressure
- brain abcess
- cerebral malaria
- Fatal familial insomnia (FFI)
- MS
- Multiple system atrophy (MSA)
- Friedreich ataxia
- Ataxia-telangiectasia
- Myoclonic epilepsy and ragged red fibers (MERRF)
cerebellar tonsil scarring
chronic traumatic encephalopathy
Prominent enlarged cells with intranuclear and intracytoplasmic inclusions
Cytomegalovirus
found w silver impregnation or for immunoperoxidase stains for axonally transported protiens
Diffuse axonal injury
caseous necrosis
TB of CNS
charcot joints
Tabes dorsalis
-loss of pain which can lead to skin and joint damage
renal angiomyolipomas, retinal glial hamartomas, pulmonary lymphangioleiomyomatosis and cardiac rhabdomyomas
Tuberous sclerosis complex
Androgen insensitivity
Spinal and bulbar muscular atrophy (Kennedy dz)
isolated loss of pain and temp in the upper extremities
Syringomyelia
extrapyramidal rigidity
Corticobasal degeneration
cloudy consciousness
meningitis
difficulty with voluntary eye movements
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
change in behavior
increased intracranial pressure
-brain abcess
hem and necrosis in mammillary bodies and the walls of the 3rd and 4th ventricles
Wernicke encephalopathy (Thiamine (vit B1) deficiency)
tumors that spread along the surface of the brain
Atypical teratoid/rhabdoid tumors
myopathy
Myoclonic epilepsy and ragged red fibers (MERRF)
(all of the symp of parkinsons)
Multiple system atrophy (MSA)
tachyzoites and encysted bradyzoites at periphery
Cerebral toxoplasmosis
extraocular palsies
Leigh synd
sensory neuropathy
Friedreich ataxia
progressive truncal rigidity
Progressive supranuclear palsy (PSP)
Atypical Parkinsonism Syndrome
myelin pallor
HIV
tufted astrocytes
Corticobasal degeneration
-Tau immunoreactivity found in astrocytes
cognitive deficits
cerebral malaria
Consist of aggregates of ectatic venous channels
Venous angiomas (varices)
Small posterior fossa
Arnold-chiari malformation type II
asscoc w prior radiation therapy to the head and neck decades earlier
meningiomas
vessels near the lesions: marked intimal proliferation or vasculitis with fribrinoid necrosis and thrombosis
Cerebral toxoplasmosis
misshapen midline cerebellum w/downward extension of vermis through the foramen magnum
Arnold-chiari malformation type II
plaque jaune
Old brain contusion
•Depressed, retracted, yellowish-brown patches involving the crests of gyri (plaque jaune).
abscesses mostly affect the cerebral cortex and the deep grey nuclei
Cerebral toxoplasmosis
acute encph characterized by numerous sharply circumscribed demyelinating leisons that undergo necrosis
Varicella-zoster virus in immunocomp ppl
ring enhancing lesions upon imaging
cerebral toxoplasmosis (NOT DEFINING)
Venous angioma of the spinal cord and overlying meninges: ischemic injury to the spinal cord and slowly progressive neuro symptoms
Foix-Alajouanine dz (angiodysgenetic necrotizing myelopathy):
ongoing myelin breakdown with lots of Mfs containing lipid-rich PAS-positive debris.
There are also lots of
active plaques of MS
wheelchair bound within 5y of onset
Friedreich ataxia
neuronophagia
- Arthropod borne viral encephalitis
- poliomyelitis in ant horn
- foci of necrosis in grey and white matter, esp single cell neuronal necrosis with phagocytosis of the debris
arrhinencephaly
Holoprosencephaly
irritability
meningitis
pill rolling tremor
Parkinsons dis
meningeal irritation
Poliomyelitis
only meninges (no neural tissue) that extends out of the opening
meningocele
greater than 20 per 10 high power fields
Anaplastic (malignant) meningiomas
tumors of similar poorly diff histology resembling medulloblastomas, from the peripheral tumor
CNS Supratentiorial primitive neuroectodermal tumors (CNS PNET)
edema and vascular congestion
rabies
aggregates of TDP-43 in nucleus, cytoplasm, or neurites
FTLD-TDP
nystagmus
MS
relative circumscription
-Pleomorphic xanthoastrocytoma
general paresis of the insane
Paretic neurosyphilis
-Insidious and progressive cognitive impairment that results in mood prbs with delusions of grandeur that will end in severe dementia
changes in personality, behavior, and language come about before changes in memory
Frontotemporal lobar degenerations (FTLDs)
small cysts within the parenchyma (soap bubbles)
crytococcal (fungal) meningitis
Widespread lesions involving white matter
embolization of bone marrow after trauma causing CVD
Parenchymal damage of the frontal lobe
Paretic neurosyphilis
-loss of neurons, proliferation of microglia, gliosis, and iron deposits
cognitive and motor deterioration
Neuronal storage dzs: Ceroid lipocuscinoses
meningitis that involves the base of the brain
Meningovascular neurosyphilis
large destructive cysts
Multicystic encephalopathy
includes rhabdoid cells
Atypical teratoid/rhabdoid tumors
CSF drainage compromised bc foramina or Luschka and Magendie not formed
Dandy-walker malformation
spastic weakness in the lower extremities
Vit B12 deficiency
Gliomas can also occur in these pts, typically these are ependymomas
NF2
Rosenthal fibers
- pilocytic astrocytoma in post fossa
- Alexander dz
hamartomas and benign tumors in the brain or other tissues
Tuberous sclerosis complex
coiled bodies
Corticobasal degeneration
-Tau immunoreactivity found in oligodendtocytes
blindness
toxic disorder from methanol
-killing off the retinal ganglion cell
chronic inflammatory cell infiltrate
Pleomorphic xanthoastrocytoma
Unilateral visual prbs
MS
- from damage to the optic nerve (optic neuritis, retrobulbar neuritis
Palsy 1+ CNs
Ischemia in the vertebrobasilar area
Lafora bodies
mycoclonic epilepsy
chronic adhesive arachnoiditis
- pneumococcal meningitis
- TB of CNS
- capsular polysaccharide of the bug can make a gelatinous exudate the promotes arachnoid fibrosis
Rosenthal fibers and eosinophilic granular bodies
Pilocytic astrocytoma
perivascular pigment laden or foamy Mfs
HIV
local paresthesias around the wound
rabies
develop renal cell carcinoma and pheochromocytoma
Von Hippel-Lindau ds
brain is protruding into the defect
Encephalocele
rigidity
- Parkinsons dis
- Huntingtons Ds LATER
neurofibrillary tangles
Alzheimers Dis
poorly differentiated
medulloblastoma
Separated by gliotic tissue with evidence of prior hem
Arteriovenous malformations (AVM)
happens around vessels, but the damage is more severe and actually kills off the small blood vessels.
Acute necrotizing hemorrhagic encephalomyelitis
Linked to fetal alcohol syndrome and HIV infection in utero
microcephaly
Microscopic foci of dialated thin walled vessels separated by normal parenchyma
Capillary telangiectasias
kyphoscoliosis
Friedreich ataxia
Pts that have many b/l grey and white matter infarcts over many years might get:
Vascular dementia
periventricular necrosis with severe brain destruction followed later by microcephaly and periventricular calcification
Cytomegalovirus
Non- Symmetrically dilated ventricles
Noncommunicating (obstructive) hydrocephalus
hypokinetic mvmt
Parkinsons dis
multiple microabscesses (maybe granulomas)
-candidiasis (fungal) Parenchymal infection in meningioencephalitis
lesions in the filum terminale
Myxopapillary ependymomas
spongiform change
- prion dis
- Leigh synd
venous thrombosis and hem infarction of the underlying brain
fulminant meningitis
-from phlebitis
Medium spiny neurons using GABA, encephalin, dynorphin, and substance P are esp affected
Huntingtons Ds
Expansion of the ependymal lined cord of the central canal of the cord
Hydromyelia
Negri bodies
rabies
- Early: pericap edema and hemorrhage
- hours: blood into white matter and subarachnoid space
- day: Pyknosis of the nucleus, eosinophilla of cytoplasm, and disintegration of the cell
brain contusion
spastiicty and choreoathetoid mvmts
cystic fibrosis
cutaneous lesions like angiofibromas, localized leathery patches (shagreen patches), hypopigmented areas (ash-leaf patches), and subungual patches
Tuberous sclerosis complex
infection from surgery of sinusitis
Extradural abscess
viral inclusions mostly found in the nuclei of oligodendrocytes and neurons
Subacute panencephalitis (SSPE)
after a while, very disabled, mute, immobile
Alzheimers dis
