CNS Flashcards
neuroglial cells
astrocytes
microglial
oligodendroglia
ependymal cells
causes for cerebral edema
trauma
bacterial or viral infection
hemmorrhage
cerebral edema can be either
vasogenic or cytotoxic
vasogenic edema is
extravascular accumulation of fluid due to its leakage across damaged wall (necrotic lesion, abcess, tumor); due to new capillary bed formation secondary to lack of good BBB
cytotoxic edema is
intracellular accumulation of fluid such as ischemia, toxin, or hypoxia –> impair cell wall function
pathology of cerebral edema
flat gyri, decreased demarcation between gray and white matter, slitlike sulci, swollen and heavier, brain herniation
clinically patient will present with what symptoms when having cerebral edema?
headache, papilledema, vomiting, due to increase of intracranial pressure
hyodrocepphalus has two categories
non-communicating and communicating
in non-communicating hydrocephalus is (obstructive) what cannot reach the subarachnoid space?
CSF
2 types of congenital non-communicating hydrocephalus
arnold chiari malformation
&
stenosis of aqueduct of sylvius or foramina of ventricles (CSF cannot reach 4 & 3rd ventricles)
arnold chiari is when the
cerebellar tonsil’s are displaced into the cervical canal through the foramen magnum
cerebellar tonsilar herniation will cause what clinically?
flattening of base of skull and hydrocephalus is present
acquired hydrocephalus types
inflammation - meningitis secondary to fibrosis, cerebral abcess
tumors
intracranial hemorrhage
acquired hydrocephalus by inflammation is caused frequently by
inflammation - meningitis secondary to fibrosis, cerebral abcess
acquired hydrocephalus by tumors is caused frequently by
ependymoma & medullablastoma
communicating hydrocephalus is due to
a blockage within the subarachnoid space
what kind of blockage can cause communicating hydrocephalus?
dural venous thrombosus
1 cause of cerebral infarction
embolism
which cerebral atery is most involved in embolism?
middle cerebral artery which is a direct extension of ICA
what type of infarct is one caused by embolism?
pale white anemic
what kind of infarct is caused by hypertension?
red hemmorragic
what is the 2nd leading cause of cerebral infarct?
ATH of the carotid, basilar, middle or cerebral artery
a detached mural thrombus from the _____ atrium will travel to
left
middle cerebral artery
types of cerebral herniation
subfalcine (cingulate)
uncinate (transtentorial)
tonsillar
subfalcine aka cingulate herniation is where
the cingulate gyrus ruptures and travels across the falx cerebri and ruptures the anterior cerebral arteries
uncinate AKA the transtentoral herniation is where
CN III is is affected
loss of consciousness
compression of aqueduct sylvius
CN III compression by uncinate herniation will present clincally as
dilaiton of pupil, impaired eye movement on same side resulting in suqinting of eyes, eyes move seperately and parasympathetic disruption
tonsilar herniation is when
the cerebrllar tonsils go through the foramen magnum –> compression of the medulla and cardiorespiratory center leading to death
types of infections of the nervous system
leptomeningitis
brain abcess
encephalitis
3 types of meningitis
acute purulent
acute lymphocytic
chronic meningitis
acute purulent type of fluid
pus –> cloudy
acute purulent type of etiology
hemophilus influenza
meningococcus
streptoccocus pnemoniae
E coli and strept agalactae
hemophilus influenza infects?
infants and children
hemophilus influenza kind of gram stain and shape?
negative bacillus (rod)
how long is infant protected from hemophilus influenza by mothers antobodies?
6 months
meningococcus affects who?
adolescents and young children
meningococcus is spread by
droplets from the nasocavity
streptoccocus pneumonia
infants and elderly affected
streptoccocus pnemoniae kind of stain and shape?
gram positive and coccus
E coli and strept agalactiae is what kind of infection
a neonatal infection
E coli and strept agalactiae gram stain and shape?
Gram + and cocci
meningococcus is neisseria is
really bad to get
which leptominigitis virus causes cerebral hemmorhages?
streptoccocus pnemoniae
acute lymphocytic meningitis
viruses with increased lymphocytes in lumbar puncture
types of acute lymphocytic meningitis
enteroviruses (mumps, coxsackieviruses, poliomyelitis)
HIV
chronic meningitis
TB
Trponema pallidum (syphilis)
brucella and
fungi - cyptococcus neoformans with AIDS
TB bacteria name
microbacterium tuberculosis
microbacterium tuberculosis type of stain and shape
acid fast bacilis
glucose will be reduced in both _____ & _____ types of meningitis
actue purulent and chronic
viral encaphalitis types
- Herpes simplex encephalitis
- Rabies
- Subacute sclerosing panencephalitis (measels)
- Acquired immunodeficiency syndrome
Most common cause of encephalitis in USA
Herpes Simplex Encephalitis
Herpes Simplex Encephalitis site
Temporal lobe and inferior parts of frontal lobe
Intranuclear inclusion bodies, Cowdry type A
rabies transmission through
saliva
rabies sites
Basal Ganglia,
Hippocampus,
Brain stem,
Intracytoplasmic inclusion bodies, Negri bodies
Subacute Sclerosing Pan-Encephalitis: transmission
Several years after measles attack (latent form) most often in children
Subacute Sclerosing Pan-Encephalitis: sites
- Cerebral grey matter (sensory or motor)
Frontal lobe –> dementia
BasalGanglia
Intranuclear inclusion bodies
etiology of intracranial hemorrhage
- Trauma: blunt (car accidents) or penetrating wounds (bullets)
- Rupture of blood vessel (congenital abnormality, hypertension, aneurysm)
- Coagulation defects
INTRACRAINIAL HEMORRHAGE types
- Epidural hematoma
- Subdural hematoma
- Subarachnoid hemorrhage
- Intracerebral hemorrhage
epidural hematoma is caused by
trauma & FX. to the middle meningeal artery or others.
epidural hematoma is located
between the skull and dura matter
Subdural hematoma
due to trauma but not a FX.
Subdural hematoma is what kind of bleed?
venous - bridging veins
Subdural hematoma can be seen more in
elderly and alcoholics due to cerebral atrophy
Subdural hematoma acute is where
bleeding is severe and associated with severe trauma such as brain lacerations
Subdural hematoma chronic is with
minor trauma and very slow bleed that leads to a clot formation
after a few day the clot in a subdural hematoma will
disintegrate and attract CSF causing expansion and slow compression on the brain
subarachnoid hemorrhage
ruptured berry aneurysm at the branching of the circle of Willis
due too >
hypertension, ATH, exercise can predispose the rupture of aneurysm
cerebral hemorrhage most common cause
hypertension causes the Charcot Bouchard micro aneurysms in Lenticulo striate branches of middle cerebral artery to rupture
cerebral hemorrhage sites
basal ganglia thalamus and internal capsule germinal matrix of premies choroid
what can cause subarachnoid hemorrhage
berry aneurysm MVA AVM > tumors coagulopathy herpes strep
what are negri bodies
intracytoplasmic inclusion bodies of present with rabies
