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NMSP > Introduction to Neuropathology- Martin (part 3 injury) > Flashcards

Introduction to Neuropathology- Martin (part 3 injury) Flashcards

1
Q

what is cerebral palsy

A

a non progressive neurologic motor defecit due to insults in the prenatal and perinatal period

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2
Q

symptoms of cerebral palsy

A

spasticity, dystonia, ataxia, paresis

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3
Q

intraparenchymal hemorrhage is often seen where?

A

in the germinal matrix of premature infants

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4
Q

what is the germinal matrix

A

the junction between the thalamus and caudate nucleus (hemorrhage here can cause the ventricles to swell and cause subarachnoid hemorrhage)

very delicate

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5
Q

what is periventricular leukomalacia

A

infarcts in the supratentorial white matter in premature infants

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6
Q

how does periventricular leukomalacia present

A

as chalky yellow plaques that are indicative of necrosis and calcifications

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7
Q

what is multicystic encephalopathy

A

extensive ischemic damage of both the white and the gray matter with large cysts

perinatal injury

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8
Q

what is ulegyria

A

this is perinatal ischemic lesions in the depths of the sulci

they cause the gyri to be thinned out and gliotic

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9
Q

what is the long term sequelae of severe pernatal or perinatal ischemic injury

A

periventricular leukomalacia

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10
Q

when you fall while awake there is usually _ contact

when you fall with LOC there is usually _ contact

skull fractures

A

occipital

frontal

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11
Q

diastatic fracture

A

fracture that crosses a suture

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12
Q

later fractures lines _ (do/do not) extend across previous fracture lines

A

DO NOT

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13
Q

displaced/depressed skull fracture

A

bone is displaced into cranial cavity by distances greater than the thickness of the bone

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14
Q

basal skull fracture

A

orbital or mastoid hematomas

“battle sign, racoon eyes)

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15
Q

symptoms of a basal skull fracture

A

otorrhea/rhinorrhea resulting in CSF drainage from the ear or nose

hinge

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16
Q

in raccoon eyes there is _ _ sparing

A

tarsal plate

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17
Q

concussion is a clinical syndrome characterized by?

parenchymal injury

A

altered consciousness secondary to head injury typically brought on by a change in momentum of the head

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18
Q

symptoms of concussion

A

transiet neurological dysfunction

transient LOC

transiest respiratory arrest

transient loss of reflexes

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19
Q

in a concussion _ recover is often complete, _ of the event often persists

A

neurologic

amnesia

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20
Q

a concussion is the dysregulation of the _ _ system

A

dysregulation of the reticular activating system

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21
Q

what is a post concussive neuropsychiatric syndrome

A

chronic traumatic encephalopathy

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22
Q

what are direct parencymal injuries

A

contusions or lacerations caused by tranmissionod kinetic energy to the brain

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23
Q

direct parenchymal injury: a blow to the surface of the. brain is transmitted through the skull and leads to rapid _ displacement, disruption of _ channels and subsequent hemorrhage, tissue injury and edema

A

tissue

vascular

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24
Q

most common locations for contusions

A

frontal lobes, occipital ridges, temporal lobes

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25
Q

direct parenchymal injury

_ _ _ most susceptible where direct force is greatest

A

crests of gyri

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26
Q

contusion

A

wedge shaped injury

base at the point of impact is broad

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27
Q

coup

A

contusion at the point of impact

28
Q

contrecoup

A

contusion diametrically opposed to coup (sudden deceleration)

29
Q

plaque jaune

A

depressed retracted yellow brown patches that are in the crests of cyri (broken down blood) from contrecoup contusion

can become an epileptic focus

old trauma lesions

30
Q

diffuse axonal injury (DAI)

timing

immunostains

A

axonal swelling and hemorragic foci

appear within hours of injury and persits for a long time

silver stain, amyloid precursor, alpha synuclein

31
Q

late manifestation of DAI

A

increased number of microglial areas and generation of tracts

32
Q

what causes DAI

A

mechanical forces

angula acceleration alone can produce DAI even in the absence of impact

33
Q

50% of indvidual that develop coma without cerebral contusions have _

A

DAI

34
Q

in diffuse axonal injury immunostains with antibodies to beta amyloid precurosr protein (BAPP) can detect the axonal lesions in _ hours after injury

what is seen on histology of DAI

A

2-3 hrs

axonal spheoids

35
Q

all shaken babies develop ?

A

brain damage

36
Q

shakikng a child on several occasions may be like second _ _

A

concussion syndrome

they dont die instantly

37
Q

when do shaken babies die

A

hours after brain swelling and DAI

38
Q

how do we recognize shaken impact syndrome

A

DAI/edema
subdural hematomas
retinal hemorrhages
subgaleal hemorrhages (b/w scalp and skull)
microscopic iron with a prussion blue stain

no skull fractures or impact sites

the child is never normal again after a fatal shaking

39
Q

seqelae of brain trauma manifest _ after brain trauma of any cause

A

months to years

40
Q

what are some late complications of brain trauma

A

prost traumatic hydrocephalus and chronic traumatic encephalopathy

41
Q

what is post traumatic hydrocephalus

A

obstruction of CSF resorption due to hemorrhage in the subarachnoid space

42
Q

what is chronic traumatic encephalopathy

A

dementia pulgilistica

a dementing illness from repeated head trauma

43
Q

what is CTE symptoms

A

atrophy, enlarged ventricles, tau neurofibrillary tangles in the gyral depths, perivascular regions and frontal and temporal lobes

44
Q

TBI/CTE is brain damage resulting from _ _ _ such as rapid deceleration or acceleration, impact, blast waves. There is associated diminished or altered _ . brain function is _ or _ impaired

A

external mechanical forces

conciousness

temporarily or permenantly

tbi - traumatic brain injury and head injury are not the same

45
Q

CTE is a brain disease linked with _ head blows

A

repeated

46
Q

CTE can only be diagnosed by?

A

examining the brain after death

47
Q

CTS occurs due to?

A

progressive loss of normal brain matter and an abnormal builup of tau protein

48
Q

most instances of CTE occur in association with the play of _ but it also has association with _ injuries and other _. Symptoms of CTE include _ and _ changes, _ loss, cognitive impairement and dementia

A

sports

blast

neurotrauma

behavorial and mood

memory loss

49
Q

CTE is a _ characterized by the deposition of hyperphosphorylated _ protein as _ tangles, _ tangles and _ in striking clusters around small blood vessels of the cortex typically at the _ _

A

taupathy

tau

neurofibrillary

astrocytic

neurites

at the sulcal depths

increase in ventricle size decrease in parenchymal mass

50
Q

what amyloid is seen in CTE

A

b amyloid

51
Q

in CTE there is depigmentation of

A

substrantia nigra

52
Q

thoracic spinal cord injury results in

A

paraplegia

53
Q

cervical spinal cord injurly results in

A

quadriplegia

54
Q

C4 or above lesions result in

A

respiratory compromise and paralysis of the diaphragm

55
Q

micro lesions in the spinal cord do what?

A

taper above and below level of injury

56
Q

acute spinal cord injury shows

A

hemorrhage, necrosis, axonal swelling

57
Q

chronic spinal cord injury results in

A

central areas of the cord becoming cystic and gliotic

58
Q

epidural space hemorrhage of the CNS is usually associated with ?

it is _ (slow/rapid)

A

skull fracture

rapid

ARTERIAL

59
Q

subdural space hemorrhage spreads _ (slowly/fast)

A

slowly

venous

60
Q

subarachnoid space hemorrhage is associated with

A

severe onset of headache with rapid neurologic symptoms/deterioration

61
Q

CTE is in the

A

depths of the sulci

62
Q

trauma/contusions have selective involvement of the ?

A

crest of the gyri (frontal and temporal lobes too)

63
Q

hypertension is centered in the deep _ matter

A

white

64
Q

in a epidural hematoma the dura is?

it is associated with _ blood

what vessel is ruptured

A

peeled off skull

arterial

medial meningeal artery

does not cross suture line

65
Q

in a subdural hematoma the dura is?

it is associated with _ blood

what vessel is ruptured?

A

still attached to the skull

venous blood

bridging vein

crosses suture line

NMSP (13 decks)

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