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Histopathology > CNS Trauma > Flashcards

CNS Trauma Flashcards

1
Q

Excess fluid in brain parenchyma

A

Cerebral oedema

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2
Q

Enlarged cerebral ventricles
Elderly
Triad of: Dementia, apraxic gait, urinary incontinence

A

Normal pressure hydrocephalus

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3
Q

Obstructed CSF flow

Physical blockage

A

Non-communicating hydrocephalus

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4
Q

No obstruction to CSF flow

Lack of CSF absorption - meningitis, SAH

A

Communicating hydrocephalus

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5
Q

Raised ICP can result in…

A

Herniation

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6
Q

Normal ICP

A

7-15mmHg

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7
Q

3 main types of herniation

A

Subfalcine (under falx cerebri - most common)
Transtentorial (inner part of temporal lobe (uncus) compresses brainstem)
Tonsilar (coning - cerebellum through foramen magnum)

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8
Q

Cerebellum through foramen magnum (coning)

A

Tonsilar herniation

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9
Q

Uncus (inner temporal lobe) pushes into brainstem

A

Transtentorial herniation

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10
Q

Brain pushes under falx cerebri

Most common type of herniation

A

Subfalcine herniation

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11
Q

Stroke symptoms <24h
Resolves without permanent brain damage
Amaurosis fugax (blurred vision)

A

TIA

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12
Q

Headache, seizure, focal neurology (if severe - vomiting, LOC)

A

Haemorrhage

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13
Q

Rupture of small parenchymal vessel
Basal ganglia
Hypertension

A

Non-traumatic intra-parenchymal haemorrhage

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14
Q

High pressure system between artery and vein prone to rupture
Massive bleeding

A

Arteriovenous malformation

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15
Q

Lesion of closely packed vessels with no parenchyma in between
Low pressure recurrent bleeds

A

Cavernous angioma

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16
Q

Rupture of Berry aneurysm (80% internal carotid bifurcation)
THUNDERCLAP headache
Xanthochromia on LP

A

SAH

17
Q

Most common site of Berry aneurysm formation

A

Internal carotid artery bifurcation

18
Q

Tissue necrosis
Permanent damage in affected area
No recovery

A

Cerebral infarct

19
Q

Fewer macrophages
Limited tissue damage
Partial recovery

A

Cerebral haemorrhage

20
Q

Direct collision of brain with skull vs. rebound collision of brain with skull

A

Coup vs. countecoup

21
Q

Panda eyes
Otorrhoea, rhinorrhoea (straw coloured CSF leaking)
BBB broken - infection risk

A

Basal skull fracture

22
Q

Injury to axons from shear force

Commonest cause of coma

A

Diffuse axonal injury

23
Q 
Repetitive traumatic brain injury (boxers, American football)
Tauopathy
Neurodegenerative disease
Suicide risk
Autopsy diagnosis
A

Chronic traumatic encephalopathy

24
Q

Lucid interval then loss of consciousness
Middle meningeal artery
Biconvex lens on CT

A

Extradural haemorrhage

25
Q

Associated with polycystic kidney disease

A

SAH (Berry aneurysms)

26
Q

Lucid interval then increasing headache + confusion
Between dura mater + arachnoid mater
Bridging veins
Crescent-shaped on CT

A

Subdural haemorrhage

27
Q

Weakness, nystagmus, blurred vision, intention tremor

A

MS

28
Q

Contralateral LEG paralysis

Cognitive deficits

A

ACA stroke

29
Q

Contralateral FACE + ARM paralysis
Dominant side affected - aphasia
Non-dominant side affected - neglect
Eye deviates towards side of lesion

A

MCA stroke

30
Q

Occipital - Contralateral hemianopia
Midbrain - CNIII and IV palsy incl. pupil changes
Thalamic - amnesia, decreased LOC

A

PCA stroke

31
Q

Sensory deficits - pain + temperature
Cross body - ipsilateral face, contralateral trunk + limbs
Ataxia + nystagmus

A

PICA stroke (Wallenberg syndrome or lateral medullary syndrome)

32
Q

Small infarcts in deep penetrating arteries of deep brain structures (basal ganglia, pons, internal capsule, thalamus)
Different syndromes
1. Pure motor (contralateral arm, leg, face) - most common, posterior limb of internal capsule
2. Pure sensory (hemisensory loss) - ventral thalamic
3. Ataxic hemiparesis (ipsilateral ataxia + leg paresis) - ventral pons or internal capsule
4. Dysarthria-clumsy hand syndrome (hand weakness, clumsiness, dysarthria, facial weakness, clumsiness) - ventral pons or genu of internal capsule

A

Lacunar stroke

33
Q

Anterior spinal artery
Hypoglossal nerve
Tongue deviation (ipsilateral tongue weakness)

A

Medial medullary syndrome stroke

34
Q

Locked in syndrome

A

Proximal basilar artery stroke

35
Q

Unconscious
Collapsed at home
Pin-point pupils

A

Brain stem infarction

36
Q

History of strokes + TIAs

Now aggressive + forgetful

A

Vascular dementia

37
Q

Blurred vision + vomiting
Diabetic
Localised to upper anterior head

A

Glaucoma

38
Q

Obese

Worsening headaches worse in morning

A

Benign intracranial HTN

Histopathology (19 decks)

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