Neuro images

Question 1

Globoid cells in Krabbe disease (AR and a galcotocerebrosidase deficiency)

Answer 1

Question 2

Cingulate (subfalcine) herniation under the falx cerebri

-compress the ACA

Answer 2

Question 3

Downward transtentorial (central) herniation

Answer 3

Question 4

Uncal herniation

the uncus: medial temporal lobe.

compresses:ipsilateral CN III (blown pupil and down and out gaze), ipsilateral PCA(contralateral homonymous hemianopsia), contralateral crus cerebri (ipsilateral paralysis, “false localization”

Answer 4

Question 5

Cerebellar tonsillar herniation into the foramen magnum

-coma death result when these herniations compress the brain stem (and inhibit respiration)

Answer 5

Question 6

angiofibromas

assoc. Tuberous sclerosis

Answer 6

Question 7

ash leaf spots assoc. tuberous sclerosis

Answer 7

Question 8

renal angiomyolipoma assoc. tuberous sclerosis

Answer 8

Question 9

cafe au lait spots

assoc with NF1

Answer 9

Question 10

lisch nodules (pigmented iris hamartomas) assoc with NF 1

Answer 10

Question 11

Glioblastoma multiforme (grade IV) astrocytoma

Answer 11

• common, highly malignant primary brain tumor
• 1 year median survival
• found in cerebral hemispheres
• can cross the corpus callosum (butterfly glioma)
• stains astrocytes for GFAP
• pseudopalisading pleomorphic tumor cells-border central areas of necrosis and hemmorrhage

Question 12

Meningioma

Answer 12

-common typically bening primary tumor of adults

0most often occurs in convexities of hemispheres nears surface of brain and parasagital region.

• arrises from ARACHNOID cells, may have a dural attachment
• often asymptomatic, may present with seizures or focal signs
• resect or radiosurgery
• women
• Spindle cells concentrically arranged in whorled patter, psammoma bodies (laminated calcifications)

Question 13

Meningioma types

Answer 13

Question 14

Hemangioblastoma

Answer 14

• adult
• most often cerebellar
• assoc. with VHL sundrome when found with retinal angiomas
• can produce EPO –> secondary polycythemia
• closely arranged, thin walled capillaries with minimal interleaving parenchyma

Question 15

Schwannoma

Answer 15

• Usually found at cerebellopontine angle
• schwann cell origin
• S-100 postive, often locallized to CN VIII –> acoustic shwannoma (acoustic neuroma).

Resectble or treated with stereotactic radiosurgery

Bilateral acoustic schwannomas are found in NF-2

Question 16

Oligodendroglioma

Answer 16

• adult
• relatively rare, slow growing
• most often FRONTAL lobes
• chicken wire capillary patter with fried egg cells (round nuceli with clear cytoplasm)
• often calcified oligodendroglioma

Question 17

Piliocytic (low grade) astrocytoma

Answer 17

• kids
• usually well circumscribed
• found in posterior fossa (cerebellum)
• could be supratentorial
• GFAP postive
• bening
• rosenthal fibers (esosinophilic. corkscrew fibers)

Question 18

medulloblastoma

Answer 18

• kids
• highly malignant cerebellar tumor
• a form of primitic NEUROECTODERMAL tumor
• can compress the 4th ventricle causing hydrocephalus
• can send drop mets to spinal chord
• horner wright rosettes and small blue cells
  gross: solid

Question 19

ependymoma

Answer 19

ependymal cell tumors most commonly found in the 4th ventricle

• kids
• can cause hydrocephalus
• poor prognosis

perivascular rosettes and rod shaped blepharoplasts (basal ciliary bodies) found near nucleus

Question 20

cranipharyngioma

Answer 20

• bening childhood turmor, may be confused with a pituitary adenoma
• most common supretentorial tumor
• rerived from rathke pouch remnant
• clacification is common
• tooth enamel like histo