images Flashcards

Intraventricular hemorrhage

Subdural (crescent shaped, does cross suture lines

Epidural (lens shaped, does not cross suture lines)

Intraparenchymal / intracerbral hemorrhage (high density bleeds most often in the basal ganglia area if due to HTN)

Subarachnoid hemorrhage (due most often to aneurysms, CT sensitivity decreases sharply with time)

ring-enhancing lesion
seen with any localizing mass with vessel proliferation
abcesses
globlastoma
mets

Cerebellar cortex.
Two Purkinje cells and numerous granular neurons.

Spinal motor neuron.
Abundant rough endoplasmic reticulum (RER) which forms aggregates, the (blue) Nissl granules.

Neuron with central chromatolysis at the left lower corner.
The RER (Nissl granules) disaggregates and the neuronal body balloons.
Three normal neurons are also seen

Pink/Red neurons or anoxic neurons
Hypoxia, ischemia, and hypoglycemia cause irreversible neuronal injury.
Injured neurons shrink, become eosinophilic due to condensation of mitochondria, and their nuclei become pyknotic.

astrocytes with processes surrounding vessels
stain GFAP positive

Astrocytes also form glial lamina- layer of tissue touching the brain parenchyma Continues with large vessels of brain and dives Deep with these vessels all the way to, but NOT Including the capillaries therefore if the CSF is Infected it penetrates via the GL

Alzheimer type II astrocytes in hepatic encephalopathy. In acute metabolic disorders such as hepatic encephalopathy, hyperammonemia, and cerebral ischemia, astrocytes enlarge. Their nuclei are large and appear clear in H&E stains.
Dendritic processes do not cover vessels well -> leaks -> edema

Perivascular (Virchow-Robin) space around a small artery. Space is filled with clear CSF. This space exists until the capillary level.

Virchow-Robbin space filled with neutrophils.
Because the BB barrier is altered secondary to the inflammation, the brain parenchyma is altered and edematous (note pale zone) and scattered neutrophils are entering the brain tissue.

hemosiderin laden macrophages (siderophages) from CSF
seen post SAH
can also see hemosiderin crystal (gold)

choroid plexus pailloma

choroid plexus papilloma

Ependymomas are predominantly tumors of children and adolescents.
They arise most frequently in the fourth ventricle and cause hydrocephalus by blocking CSF flow.
good prognosis with skilled surgeon

ependymoma

epidural bleed
contained by sutures

subdural bleed
not w/in suture lines

beta amyloid build up in DAI

axonal swelling of DAI d/t beta amyloid precurosor build up
don’t confuse with red/pink neurons- note no nuclei present

Descending corticospinal tract Wallerian degeneration d/t severe DAI

tau build up in chronic repetitve head injuries with DAI

tau build up in chronic repetive head injuries and DAI

1) sulfalcine
2) central
3) uncal transtentorial
4) tonsillar

Duret hemorrhage

Duret hemorrhage