CNS histopath Flashcards
Transient ischaemic attack
S/Sx: amaurosis fugax, carotid bruit
Arthrogenic debris from carotid travels to opthalmic (internal carotid).
Ix: carotid USS, cardiovascalar RFs.
Tx: aspirin, dipyridamole, ?carotid endarterectomy.
Stroke
Commonly MCA.
Ix: CT/MRI - clot or bleed?
and cardiovascular RFs.
Tx: aspirin, ?dipyrimidole, thrombolytics if
Brain haemorrhages -
2 traumatic and 2 not
Traumatic: EDH and SDH;
Non-traumatic: SAH and intraparenchymal.
Extradural haemorrhage
Skull fracture, ruptured middle cerebral artery,
Rapid arterial bleed,
Lucid then LoC.
Subdural haemorrhage
Elderly or alcoholi,
minor trauma,
slow venous bleed, fluctuating consiousness.
Assoc with brain atrophy.
Subarachnoid haemorrhage
85% from ruptured berry aneurysms, most at bifurcation of internal carotid.
F>M,
Intraparenchymal haemorrhage
50% due to hypertension.
Sudden onset
Charcot-bouchard microaneurysms, likely to rupture.
Commonly in basal ganglia.
Traumatic parenchymal brian inuries
- Concussion: Transient LoC, paralysis, recovery in hours..
- Diffuse axonal injury: vegetative state.
- Contusions: brain hits skull.
- Coup: site of impact.
- Contrecoup: opposite impact.
Causative agents of bacterial meningitis
Neonates: GBS, E coli, Listeria;
Young children: Strep pneumoniae, Hi.
Adolescents: N meningitidis, Strep pneumo.
Elderly: Strep pneumo, E coli.
Brain tumours
Astrocytomas mainly.
Buzzwords:
- NF2: meningioma,
- ventricula tumour, hydrocephalus: ependymoma,
- indolent, childhood: pilocytic astrocytoma,
- soft, gelatinous, calcified: oligodendroma
Pathological proteins in dementia
Lewy body: ubiquitin and alpha-synuclein.
Alzheimer’s, Pick’s, FTD (Chr17): all have Tau.
Alzheimer’s: beta-amyloid also.
Alzheimer’s -
features, MRI, Tx
Dementia.
Generalised atrophy: wide sulci, narrow, gyri, large ventricles.
Tx: symptomatic: anti-Cholinesterases, nACh-R agonists, Glu blockers.
Lewy body dementia
Fluctuating cognition, visual hallucinations.
Pathologcally same as Parkinson’s.
