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Pathology > CNS Trauma & Hydrocephalus > Flashcards

CNS Trauma & Hydrocephalus Flashcards

1
Q

Components of the brain

A

-Cerebrum
- Cerebellum
- Brainstem- Midbrain, Pons & Medulla

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2
Q

Histology of the brain

A

Neurons - dendrites, body, axon & synapse
Glia - Astrocytes, Oligodendrocytes, Microglia & Ependymal cells

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3
Q

Meninges

A
  1. Dura - Outer most dense collagenous tissue
  2. Arachnoid- Middle loose connective tissue
  3. Pia mater - Inner most layer
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4
Q

Uniqueness of the brain

A
  1. Closed box - pathological inc. ICP and its consequences
  2. Autoregulation of blood flow - Unable to autoregulate after a limit
  3. BBB - Some drugs cant cross
  4. Little/ No lymphatics - Impaired resorption of edema fluid
  5. Functional localization - Focal neurological deficits
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5
Q

Cerebral Edema

A

Accumulation of excess fluid within the brain parenchyma

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6
Q

types of Cerebral edema

A
  1. Vasogenic
  2. Cytotoxic
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7
Q

Vasogenic Edema

A

Disruption of BBB –> Fluid from vascular component –> Extracellular space

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8
Q

Cytotoxic edema

A

Injury to neuronal, glial or endothelial cell membranes –> Inc in intracellular fluid

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9
Q

Causes of vasogenic edema

A
  • Meningitis, encephalitis, trauma & metastasis
  • Paucity of lymphatics
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10
Q

Causes of cytotoxic edema

A
  • Hypoxia/ ischemic insult
  • Metabolic damage
  • anything that injures the cells
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11
Q

Hydrocephaluis

A

Accumulation of CSF within the ventricular system

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12
Q

Causes of Hydrocephalus

A
  1. Obstruction of flow of CSF
  2. Impaired CSF resorption
  3. Excess CSF production
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13
Q

Clinical features of Hydrocephalus

A
  • Inc head circumference (before suture closes)
  • Ventricular expansion & Inc ICP (after suture closes)
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14
Q

Types of Hydrocephalus

A
  1. Non-communicating
  2. Communicating
  3. Ex vacuo
  4. Normal pressure
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15
Q

Cause & result of Non-communicating Hydrocephalus

A

Obstruction of CSF flow –> Blocks CSF circulation from ventricles to arachnoid space
- Only affected portion of ventricle enlarges

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16
Q

Cause & result of Communicating Hydrocephalus

A

Poor absorption of CSF by arachnoid villi OR Overproduction of CSF
- Entire ventricle system enlarged

17
Q

Causes of Ex-vacuo Hydrocephalus

A

Infarctions or Neurodegenerative disorders –> Loss of brain volume
- Secondary inc in CSF volume

18
Q

Normal pressure Hydrocephalus

A
19
Q

Clinical features of Normal pressure Hydrocephalus

A
  • Gait disturbances (Wobbly)
  • Dementia (Wacky)
  • Urinary incontinence (Wet)

WET, WACKY & WOBBLY

20
Q

Treatment of Normal pressure Hydrocephalus

A

Lumbar punctures/ CSF shunting

21
Q

Pseudotumor Cerebri / Idiopathic Intracranial Hypertension

A
22
Q

Epidemiology & etiology of Pseudotumor cerebri

A
  • Overweight women of childbearing age
  • Unknown cause
23
Q

Clinical features of Pseudotumor cerebri

A

Increased ICP
- headache
- diplopia (CN6 palsy)
- vomiting
- papilledema –> vision loss

24
Q

Treatment of Pseudotumor cerebri

A
  • Lumbar punctures
  • Acetazolamide
  • Shunt
25
Q

Cerebral herniations

A

Displacement of brain tissue past rigid dural folds or through openings in the skull

26
Q

Clinical features of Cerebral herniation

A
  • Compromised blood supply
  • Infarctions
  • Edema
  • Specific symptoms depending on area involved
27
Q

Types of Cerebral herniations

A
  1. Subfalcine/ Cingulate
  2. Tonsillar
  3. Transtentorial/ Uncal
28
Q

Subfalcine herniation

A
29
Q

Tonsillar herniation

A
30
Q

Transtentorial herniation

A
31
Q

CNS Trauma

A
  1. Skull bone fractures - Sharp vs blunt; Linear vs depressed vs basilar
  2. Brain parenchymal injury - Concussion, contusion, lacerations, diffuse axonal injury, coup vs countercoup injury
  3. Vascular injury - Epidural, Subdural, subarachnoid & intraparenchymal
32
Q

Linear fractures

A

Straight & sharply defined

33
Q

Depressed fracture

A

Fractured edges overlap

34
Q

Basilar fracture

A

Fractures in the base of the skull

35
Q

Concussion

A

Clinical syndrome of reversible altered consciousness ff head injury

36
Q

Etiology & Pathogenesis of Concussion

A
  • Head trauma
  • Dysregulation of the Reticular Activating System in the brainstem
  • No parenchymal brain injury
37
Q

Clinical features of Concussion

A
  • Transient loss of consciousness
  • Headache
  • Amnesia of event
  • Inability to focus or concentrate

Pathology (7 decks)

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