CNS Pathology Flashcards
Leptomeningitis
an inflammatory process that is localized to the interfacing surfaces of the pia mater and arachnoid mater, where CSF flows
Pachymeningitis
inflammation of the dura due to chronic sinus infection or mastoiditis. The dura serves as a barrier and inflammation is restricted to the outer surface
What organisms cause meningitis in neonates
E. coli
Group B Strep
What organisms cause meningitis in infants 3mo to 3yrs
H. influenzae
What organisms cause meningitis in adults
Strep pneumo
What causes meningitis in military barracks
Neisseria meningitidis
What is the definitive dx of meningitis
neutrophils in CSF
Which cell type dominates in a viral meningitis
lymphocytes
Ex causes TB, fungal
What are gross characteristics if bacterial meningitis
Opacification of arachnoid- creamy white exudate made of PMNs and fibrin
-will travel along the spinal cord as well because it is connected to the brain
What are the classic signs of meningeal infection
- nuchal rigidity
- head retraction
- spontaneous flexion of the knees and hips when the neck is flexed-Brudzinski sign
- Kernig’s sign
What is Parkinson’s disease
loss of neurons in the substantia nigra
Clinical manifestation of Parkinson’s disease
pill-rolling tremors, muscle rigidity. emotionless face, and emotional lability
- drooling
- most cases are idiopathic
- increased incidence of dementia and depression
What are some causes for Parkinson’s disease
- Viral Encephalitis
- most cases are idiopathic
- ingestion of MPTP chemical
- old age
What are gross examination characteristics of Parkinson’s disease?
- loss of pigmentation of substantia nigra
- atrophic nerve cells have lewy bodies
- microscopically: pigmented neuron scarce
- extracellular deposits of melanin from necrosis of neurons
What are some physical features of Parkinson’s disease
- eyes unblinking, staring
- drooling, mouth open
- stooped posture,
- cog-wheel rigidity
What other things cause Parkinson’s like syndrome?
- manganese poisoning
- hydrocephalus
- tumors near basal ganglia
- drugs: phenothiazine, haldol
- infarcts of basal ganglia
What is Alzheimer’s disease?
-progressive insidious disease that impairs cognitive function, loss of memory and leads to dementia
What is the pathology behind Alzheimer’s disease?
beta-protein amyloid deposition in senile plaques
-they are found in cerebral cortex in the intelligence zone and the in the cerebral blood vessels
What are gross examination characteristics of Alzheimer’s disease?
- narrowing of gyri
- widening of sulcus
- loss of 200 grams of brain mass in 3 to 8 yrs
What are the microscopic findings in Alzheimer’s disease
- senile neuritic plaques silver staining neuritic process around a beta core in hippocampus and amygdala
- neurofibrillary tangles /flame cells
- amyloid angiopathy
What is the clinical presentation of Alzheimer’s disease
- loss of memory
- difficulty with language
- patients become mute incontinent and bedridden
- terminal bronchopneumonia is usually the cause of death
WHat is multiple sclerosis
chronic demyelinating disease of CNS with both motor and sensory sections affected
What are risk factors for MS
- women
- mean age at 30 yrs of age
- genetic: twins and increased risk in 2 and 3rd degree relatives
- immune: perivascular lesions with a lot of Cd4 and CD8 cells
- infectious JC virus, Mumps, Rubella, Herpes, Measles
What is the hallmark of MS?
-white matter plaques
What is a berry aneurysm?
arterial defect during embryonic development
- point of congenital muscle weakness
- occur in circle of willis
What is HTN associated aneurysms/Charcot-Bouchard?
-lipohyalinosis deposits in the cerebral arterioles causes them to weaken an rupture
What are the sites of Hypertensive Intracerebral Hemorrhage from most common to least?
-basal ganglia-thalamus-75%
-pons-15%
cerebellum-10%
What is an intraventricular hemorrhage?
- small vessels ruptures in the ventricle and distend it with blood causing death
- compression of the vital centers in the medulla
Cerebral hemorrhage vs cerebral infarct
cerebral infarct: emboli causes ischemia and the infarction
cerebral hemorrhage: hematoma ruptures and then bleeds into the cerebellum
