Histopathology 19: Cerebrovascular Disease And Trauma

Question 1

What are the 2 types of hydrocephalus ?

Answer 1

Non-communicating

Communicating

Question 2

What is the main cause of non-communicating hydrocephalus ?

Answer 2

The choroid plexus gets stuck in the cerebral aqueduct blocking csf flow

Question 3

What is a common cause of communicating hydrocephalus?

Answer 3

Meningitis infection- causes inflammation of the meninges which blocks csf reabsorption into the venous sinuses

Question 4

What are the 3 main types of herniation in the brain ?

Answer 4

• Subfalcine herniation
• uncal herniation (medial temporal lobe down through the tentorial notch)
• Tonsillar herniation (coning)- cerebellum is pushed through the foramen magnum

Question 5

What features can be seen on histology suggesting AVM (atrioventricular malformation) ?

Answer 5

Complex intertwining vessels

Question 6

What is the characteristic sign of Cavernous Angioma on MRI ?

Answer 6

Target sign on T2 weighted MRI

Question 7

What is a non-traumatic Intra-parenchymal haemorrhage ?

Answer 7

Haemorrhage into the brain parenchyma due to rupture of a small intraparenchymal vessels

Most commonly into the basal ganglia

Question 8

What is the most common cause of non-traumatic intra parenchymal haemorrhages ?

Answer 8

Hypertension

Question 9

With which symptoms/signs can a fissure fracture present ?

Answer 9

Otorrhoea- CSF fluid leaks out of the ears
Rhinorrhoea- CSF fluid leaks out of the nose

Battle sign and raccoon eyes

Question 10

Rotational traumatic brain injury tend to cause damage to which structures in the brain ?

Answer 10

Midline structures - corpus callosum, rostral brainstem, septum pellucidum

Question 11

Describe the features of subarachnoid haemorrhage ?

Answer 11

• Haemorrhage in the subarachnoid space.
• Caused by ‘berry’ aneurysm, hypertension, trauma, AVM - severe ‘thunder clap’ headache radiating to the occiput - associated with polycystic kidney disease, coarctation of the aorta

Question 12

Describe the features of extradural haemorrhage ?

Answer 12

• Bleed above the dura due to damage to the middle meningeal artery
• associated with severe trauma and fracture to the pterion
• subsequent lucid interval.

Question 13

Describe the features of Intracerebral haemorrhage (haemorrhage stroke) ?

Answer 13

• Caused by hypertension and arteriovenous malfor- mations.

- Hypertension may lead to either hyaline arteriosclerosis or Charcot–Bouchard aneurysms.

Question 14

Describe the features of subdural haematoma ?

Answer 14

• Bleed between the dura and arachnoid due to an acute tear in bridging veins.
• caused by trauma.
• features of raised intracranial pressure (headaches, confusion, nausea and vomiting), altered mental state
• Insidious onset usually taking 48 hours