Histopathology: Cerebrovascular disease and trauma

Question 1

Accumilation of excess fluid within the brain parenchyma. Due to disruption of the blood-brain barrier. What is this condition?

Answer 1

Cerebral oedema (Vasogenic)

Question 2

Accumilation of excess fluid within the brain parenchyma. Due to increased intracellular fluid secondary to neuronal and glial cell injury. What is this condition?

Answer 2

Cerebral oedema (Cytotoxic)

Question 3

An increase in the volume of CSF within the ventricular system. What is this condition?

Answer 3

Hydrocephalus

Question 4

Usually caused by impaired flow or decreased resorption of CSF. What is this condition here?

Answer 4

Hydrocephalus

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Can be communicating or non-communicating

Question 5

Increases in brain volume, either by increased CSF volume, cerebral oedema, haemorrhage or tumour cause what?

Answer 5

Raised ICP

Question 6

What is the main complication of raised ICP?

Answer 6

Herniation: of brain tissue from one compartment to another

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“3 possibilities”

Subfalcine herniation

Transtentorial herniation (Most common and significant)

Tonsillar herniation

Question 7

77 year old man, presents with rapid onset of focal CNS signs and symptoms (eg hemiplegia and hemiparesis. History of hypertension. On examination he has a carotid bruit. Head CT shows no signs of bleeding. Most likely diagnosis?

Answer 7

MCA infarct

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Other infarct options:

ACA: personality based, executive function problems

MCA (Classic): hemiplegia, sensory loss. language difficulty.

PCA: visual disturbances

Diffusion-weighted MRI diagnoses acute infarct.

CT helps rule out primary haemorrhage

Question 8

54 year old man, history of hypertension. Sudden onset of loss of hearing with headaches and nausea. Head CT shows a haematoma. Most likely diagnosis?

Answer 8

Intracranial haemorrhage

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I wrote this pretty quickly so it isn’t totally out the question it could be another form of stroke.

Usually occurs in late middle age

3 main causes:

• Vascular wall injury (eg hypertension)
• Strucutral defecgs such as AVMs
• Tumours (Space occupying lesions)

Question 9

77 year old man. Sudden onset headache “like being struck on the back of the head” while going out for a walk. Most likely diagnosis?

Answer 9

subarachnoid haemorrhage

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‘Thunder clap’ head ache

Can be caused by anuerysms that can be repaired surgically