Intro to Neuropathology - Fremont Smith Flashcards
toxic/metabolic causes of neuropath
DEENO
drugs, endo, electrolytes, nutrition, organ failure
acute and urgent
trauma and vascular issues
sub-acute and urgent
epilepsy
chronic and urgent
hydrocephalus
pain
only meninges have pain fibers
crossed effect
brainstem lesion
-head and limbs C/L symptoms
relapse and remission over years
multiple sclerosis
loss of mental power
dementia - not disease entity
-can happen with any pathology causing brain damage
blood on CT
bright white
fibrinolysis - clot isodense with brain at 1 week
hypodense week 2-3
density of clot -used to date and time bleed
CT scan
hypodense - black - air, fat - dark grey - water
hyperdense - white - bone and blood
“blood can be very bad”
blood cisterns brain ventricles bones
lens shape
epidural
crescent shape
subdural
cistern
opening of SA space of brain created by separation of arachniod and pia mater
look if blood or if cistern open - on CT scan
4 key cisterns - circummescencephalic, suprasellar, quadrigeminal, sylvian
brain exam on CT
symmetry
grey-white differentiation - early sign of CVA
shift
hyperdensity - lighter / hypodensity - darker
ventricles on CT
look for 3rd, 4th, and lateral ventricles - dilation or compression
bone on CT
white - hyperdense
-look for fractures
ring lesion
on CT - white around lesion - from neovascularization
MRI of brain
T1 - like CT scan
T2 - water bright - seem edema, gliosis, and gray matter prominent
flair MRI
to make CSF dark - for small abnormalities
spiral CT
with contract - to view blood vessels
MRA
magnetic resonance angiography
- gadolinium to enhance contrast
- method of choice for vessel narrowing, thrombosis, and dissection**
CNS myelin
oligodendrocytes
PSN myelin
schwann cells
neuropil
extracellular space of brain
-axons, dendrites, and collections
empty space around neuron
can be just artifact
nissl substance
seen in the cell body of neuron only
-rough ER
silver stain
shows axons and dendrites
axon severed - first change seen
nissl to periphery - chromatolysin**
neocortex layers
MGP GPM
1-molecular 2-external granular 3-external pyramid 4-internal granular 5-internal pyramid 6-multiform
cerebral cortex
3 parts
- archicortex - limbic system to cortex
- paleocortex - to olfactory system
- neocortex - 90%
central chromatolysis
if axon severed - nissl granule dissintegrate - neuron body balloons
reversible change that develops during repair of neuron that has been disconnected from target
red neuron
irreversible - hypoxia, ischemia, hypoglycemia
neuron shrink, become eosinophilic (mito condense), nuclei pyknotic
aka anoxic neuron
tau protein
in microtubule of axon
T lymphocytes
can cross BBB
astrocytic processes
help maintain BBB
10x more astrocytes than neurons
GFAP
stain for astrocytes
-glial fibrillary acidic protein
indicator of chronic CNS injury
gliosis - astrocyte hyperplasia and hypertrophy
microglial cells
CNS macrophages
death of neuron
12-24 hours - as red neuron
glia limitans
interdigitating astrocytic process on surface of cortex
-around vessels - until become caps
allow inflammation to get into brain parenchyma
hepatic encephalopathy
get alzheimer type II astrocytes
indicate cerebral edema
increased ammonia - injures brain
six causes of dementia
stroke and ischemic encephalopathy hippocampal sclerosis head trauma hydrocephalus CNS infection metabolic CNS disorder demyelinating disease neurodegenerating disease neuropsych disorder severe medical illness or organ failure
