CNS 1 Flashcards
Do neurons divide in an adult?
NO
What needs more O2… neurons or astrocytes?
Neurons!
Cytotoxic vs vasogenic cerebral edema…
Cototoxic == swelling of cells with injury! REVERSIBLE
Vasogenic == leaking of cells – irreversible!
Subfalcine herniation
Cingulate gyrus under fall
Transtentorial herniation
Temporal lobe under tentorium
*life threatening
Tonsillar herniation
Tonsils through foramen magnum!
Worst one!
Life threatening!!
Concussion vs contusion
Concussion == trauma causing altered mental state
Contusion = bruising of the brain
Diffuse axonal injury
Often caused by trauma – acceleration or deceleration
== degeneration of axons in white matter – can lead to a vegetative state
Do epidural or subdural hematoma cause more pressure?
Epidural hematoma!
Epidural = meninges artery
Global cerebral ischemia
Often from cardiac arrest – lack of O2 globally
Transient Ischemic Attack – TIA
NOT a stroke!
You recover very fast
2 types of stroke…
Which is more common
Ischemic - block of blood supply
Hemorrhagic – brain bleed
Ischemic is 85%!
2 types of infarct… which is worse?
Core and penumbra
Core is worse! - death!
Blood is Neurotoxic!
True
Where do saccular aneurysms typically occur?
At the branch point of the circle of Willis
What is the most common brain tumor?
Metastatic tumors are most common…
But of primary tumors.. gliomas make up 80%
meningiomas vs. glioblastoma vs. oligodendroglioma vs. ependymoma
Meningioma = on outside of brain… good prognosis (I or II)
Glioblastoma = grade IV, 1 year to live
Oligodendroglioma = better prognosis
Ependymoma == very hard to reach and treat
Triad of symptoms of meningitis…
What are the two kinds and which one is worse?
Triad
- fever
- stiff neck
- headache
Acute pyogenic (bacterial) = BAD Acute viral = just rest
Encephalitis is what..?
What are the symptoms of mild and severe?
Inflammation of the parenchyma (functional tissue of brain)
Mild = flu like symptoms
Severe = seizures and coma
Neurofibromatosis Type I characteristics
3 major subsets…
Progressive development of tumors!
- Neurofibromas – benign of Schwann and fibroblasts
- Gliomas – often at the optic nerve
- Cafe at lait spots – >6 - flat
Multiple Sclerosis
Clinical features
Cause
Histopathic characteristics
Prognosis
Clinical = slowed conductance
Cause - autoimmune attacking myelin in the CNS
Histo - MS plaques
Prognosis - most common is relapsing
Alzheimers
Clinical features
Cause
Histopathic characteristics
Prognosis
Clinical = impairment of memory, dimentia
Cause = neurons dying globally
Histo = senile plaques (AB amyloid) neurofibrillary tangles (tau), amyloid angioplasty - AB protein weaken vessel walls
Prognosis - meh provisional
MOST COMMON
DIAGNOSED AT AUTOPSY
Parkinson’s
Clinical features
Cause
Histopathic characteristics
Prognosis
Clinical = tremor, bradykinesia
Cause – loss of dopaminergic neurons (especially in substantia Nigra)
Histo - Lewy body deposits
Prognosis - meh
Lewy Body Dimentia
Often with Parkinson’s
Lewy bodies in brain
REM sleep disorder, hallucinations
ALS – Amyotrophic lateral sclerosis
Clinical features
Cause
Histopathic characteristics
Prognosis
Clinical =
UPPER –> spastic, strong reflexes
LOWER –> paralysis, weakness
Cause – loss of upper and lower motor neurons
Prognosis – in 50’s, not good .. locked in syndrome – death from respiratory failure
Can live with ventilator!
Traumatic Brain injury (TBI)
Mild vs. severe
Mild = dimentia pugilistica, pugilistic Parkinsonism
Severe = risk factors for Alzheimer’s and Parkinson’s
Sports repeated injuries!
