Exam 3 - nervous system pathology Flashcards
Coup and counter coup
coup = initial blow. site of impact
countercoup = opposite site of impact
Epidural hematoma
- arterial bleed
- btwn bone and dura
- crescent-shaped on scans
Subdural hematoma
- venous bleed
- btwn dura and arachnoid membrane (takes shape of brain)
- *slowly enlarging clot
- *consciousness fluctuates
pt has a massive midline shift and follows shape of brain. what bleed is this?
Subdural hematoma
TBI 2 phases
phase 1 = rotational forces. (hallmark of TBI)
phase 2 = inflammatory
Global hypoxic injury
- not enough oxygen to brain
- cerebral atrophy -> apoptosis of neurons = **RED NEURONS
- watershed zones infarct
What are the signs of a stroke?
FAST!!
- face fallen on one side
- arms - cannot raise
- speech - slurred
- time! to call 911
Thrombotic stroke
MCA most common location
-pale infarctions on exam
Embolic stroke
- ischemic due to embolus
- aka hemorrhagic stroke (***looks red)
intracerebral hemorrhage
- HTN cause stress. get microaneurysms. ruptures. hemorrhage
- basal ganglia
Worst headache of life
=berry aneurysm
Stepwise progression of stroke symptoms
lacunar infarct
Anencephaly
absence of most of brain and skull
spina bifida
fetal spinal column doesnt close
meningocele
herniation of meninges thru spinal column defect
meningomyelocele
herniation of meninges and spinal cord thru spinal column defect
Extension of the medulla and cerebellar vermis through the foramen magnum =
Arnold-Chiari malformation
partial or complete absence of cerebellar vermis =
Dandy-Walker malformation
Syringomyelia
- cyst in spinal cord
- loss of pain and temp sensation in arms and upper pec area
MS
- most common demyelinated disease
- Pathogenesis is T helper cell mediated
younger to middle aged female comes in with blurry vision and difficulty with urination what auto immune disorder should you be looking for?
MS!!!
Pseudotumor cerebri
-idiopathic intracranial HTN
-diagnosis of exclusion
-Edema around optic nerve
Goal: lower CSF pressure
Wernicke vs korsakoff
Wernicke = reversible
Korsakoff = irreversible
Meningitis
- inflammation of pia mater
- starts with blood infection
- have fever, stiff neck, headache
Encephalitis
inflammation of brain parenchyma
-fever, headache, impaired mental status
Primary brain tumors in kids vs adults
kids = majority below tentorium cerebelli ***
adults = majority above tentorium cerebelli ***
Astrocytoma (kid/adult location)
-most common neuroglial tumor
kids = cerebellum adults = frontal lobe
Glioblastoma
- high grade astrocytoma
- crosses corpus callosum
Common cause of new seizures
meningioma
Apendymoma (kids/adults location)
adults = cauda equina
kids = fourth ventricle
medulloblastoma
- malig
- small cell
- likes to seed the neuroaxis (invade other areas)
Oligodendroglioma
- benign
- fried egg cells
Lymphoma in CNS majority are
metastatic non-Hodgkins
