Nervous system Flashcards
GBS
acute inflamatory demyelinating neuropathy
dec nerve conduction velocity
inc csf proteins
dec reflexes
Chronic inflamatory demyelinating polyradiculopaty
2m +
recurrent de and re myelination
proliferative onion bulb schwann cells
steroid responsive
leprosy
schwann cells invaded by mycobacterium
sympetric polyneuropathy, esp pain
Diphtheria neuropathy
bulbar and resp dysfunction
Vitamin eficiecy neuropaty
B1,6,12 folate, vitmain E, copper, zinc
Skull ~ clasification
displaced if >thickness bone
diastatic if crosses suture lines
DAI
asymmetrical swelling axons deep white matter
present in 50% who develop coma
SDH time frame blood removal
1 week - clot lysis
2 weeks - fibroblasts from dural space into haematoma
1-3m - hyalinoid CT
Brain CO and O2 consumption
15% CO 20% O2 consumption (same as skeletal muscle)
Effect ischaemia on brain
dec ATP and dec membrane potential
inc Ca2+ causing cellular injury
inc glutamate release further inc ca2+ into cell (via NMDA)
BP for global cerebral ischaemia
<50 systolic (autoregulation 50-150)
morph global cerebral ischaemia
12-24h red neurons, eosinophilia, pyknosis
24h-2w necrosis, macrophages, reactive gliosis
2w + removal necrotic tisssue, gliosis
astrocytes from 1w
cerebral embolism
most common cause focal ischaemia
main from cardiac mural then carotid
cerebral thrombosis
plaque rupture
carotid bifurcation, origin mca, basilar
gross morphology brain post thrombosis
48h pale
2-10d gelatinous
2-3w liquefactive
Lacunar infarcts
<15mm
lenticular nucleus and thalamus and internal capsule
tissue loss surrounded by gliosis
HTN CVD sequelae
lacunar infarcts
split haemorrhage
encephalopathy
ICH - mostly putamen