Gianani Final CIS Flashcards
What is diffuse axonal injury?
a type of traumatic brain injury a complication of herpes virus encephalitis a symptom of parkinson disease synonymous with MS The first sign of ALS
A type of traumatic brain injury. Seen when neurons are stretched from rapid acceleration/ deceleration.
What do we see in Herpves virus
- you will see Cowdry inclusions.
Progressive Multifocal Leukoencephalopathy
Jc and Bk virus –>
lesion of oligodendrocytes –> demyelination
Affects immunocompromised
inclusions are in the nucleus
Tau deposition is related to
- ALS
- Traumatic encephalopathy
- Parkinson disease
- Cerebral Amyloid Angiopathy
- Gillan- Barre syndrome
Traumatic encephalopathy
repetitive mild head injury with tautopathy (deposition of tau protein)
Guillan Barre syndrome
progressive demyelination of peripheral nerves
CSF protein content is high. Other disease with high protein in the CSF: meningitis
Cerebral Amyloid Angiopathy
- degenerative disease
- amyloid
- in a clinical vignette, an elderly person but without HTN might be a good candidate
protein involved in Parkinson’s disease
synuclein, which is also involved in Lewy Body Dementia
ALS
a neuropathy of the upper and lower neurons
You would see a secondary change in the muscles
Beta-2-transferrin testing is used in the evaluation of
- Basilar skull fracture
- Meningitis
- Hypoxic ischemic encephalopathy
- Oligodendroglioma
- Meningioma
Beta-2-transferrin is a protein present in the CSF but not in the serum
used to diagnose Basilar skull fracture
Oligodendroglioma genetics
19q (long arm)
worst location for meningitis
basilar meningitis is associated with tuberculous
CN that can be involved: VI
issues that –> elevated protein level in CSF
neoplasms
bacterial meningitis
MS (oligoclonal)
Guillan-Barre syndrom
viral or low-grade bacterial agent (like campylobacter)
immune response that attacks the nerve cells of the PNS and their support structures–> Guillain Barre
vitamin deficiency in the differential dx for peripheral neuropathy
Vitamin B12
also can be related to dementia
Is the ApoE genetic locus associated with AD?
yes
in familial forms we see AD earlier
also in trisomy 21
most frequent site of the neurofibrillary tangles of tau are found in AD
medial temporal cortex
alpha-secretase activity in AD
may prevent accumulation of Abeta protein
difference between demyelinating disease and MS?
MS is a subset of it.
Others: Neuromyelitis Optica- Auto Abs against aquaporin-4, a water channel of astrocytes
Progressive Multifocal Leukoencephalopathy
Guillain-Barre syndrome
intranuclear inclusion plus demyelination =
PML. You will see demyelination of the cerebellum and pons.
The pathology of ALS involves
- degenerative disorder of upper and motor neurons
- Loss of substantia nigra
- autoimmunity
- necrosis of muscular tissue
- peripheral neuropathy
degenerative disorder of upper and motor neurons
dementia appears at the onset or develops later in a significant proportion of ALS patients
relentlessly progressive. Majority of patients die, usually from respiratory paralysis, within 2-3 years of onset.
pilocytic astrocytoma
children
cerebellum/ optic nerve
good prognosis
glioblastoma multiforme
grade four astrocytoma
ependymoma
ependymal cells line the CSF
–> hydrocephalus
vasculor pseudo-rosette + hydrocephalus, code word for
ependymoma
Virkow-Robbins spaces are
associated with the subarachnoid space
sites of CSF foration
- choroid plexus of the vevntricle cavities, mostly is formed in the lateral ventricles
- some originates from the ependymal cells lining the ventricles
- Some from the brain substances through perivascular spaces
Movement of the CSF inside the ventricle is controlled by the
- Pulsation of the artery in the choroid plexus
2. by the aid of the cilia and microvilli of the epenymal cells
xanthochromia of the CSF?
yellow discoloration of the CSF due to oxyhemoglobin which appears in 4-6 hours and bilirubin which appears in 2 days.
eliotropism is the same thing
blood in the CSF
if it’s only in the first tube, it was traumatic lumbar puncture
if it’s in subsequent ones, subarachnoid hemorrhage
first step with lady who has bad headaches?
rule out migraines
ring-enhancing lesion?
glioblastoma multiforme, e.g.
serpentine palisading necrosis, cellular proliferation and endothelial proliferation
buzzwords for glioblastoma
Neurocysticercosis
commonest global parasitic infection of the CNS and leading cause of epilepsy worldwide
cystercercus cellusosae, Taenia solium larvae
Pork meat –> patients become definite host
Cysticercosis as intermediate host- muscle, other organs
Variable manifestation, some asymptomatic
There is an inflammatory reaction following the parasite’s death
eventual calcification
CNS involvement in AIDS
direct: HIV encephalitis
indirect- infectious- toxoplasmosis, cryptococcus, PML
- neoplastic: lymphoma
cells that PML affects?
oligodendrocytes
Cerebral lymphoma
PCNSL is typically a diffuse large B-cell lymphoa (DLBCL)
the tumors that arise in immunocompromised patients are EBV-positive
