Neuropath Lecture 1

Question 1

Causes of intracranial pressure

Answer 1

Focally expanding mass

CSF accumulation

Vascular congestion

Brain edema

Question 2

Consequences of intracranial pressure

Answer 2

Local deformity, reduced volume of CSF and distortion of the brain

Internal herniation

Ischemic brain necrosis

Question 3

Result of internal herniation

Answer 3

Hemorrhagic infarction

and/or

Tissue compression

Question 4

4 types of herniation

Answer 4

Supracallosal subflacine

Transtentorial

Foraminal

Transcalvaria

Question 5

Herniation

Supracallosal subfalcine

Answer 5

Cingulate gyrus slips beneath meninges

Question 6

Herniation

Transtentorial

Answer 6

Occipital cortex slips beneath tentorium, compressing midbrain which it displaces posteriorly

Question 7

Herniation

Foraminal

Answer 7

Most common

herniation of the cerebellum may compress and thus disrupt function of the respiratory centers within the brainstem

Question 8

Herniation

Transcalvarias

Answer 8

Trauma or surgery

Question 9

Increase in volume of all or part of the brain

Answer 9

Brain swelling

Question 10

Enlargement of the brain resulting in elevated intercranial pressure caused by an

increased diameter of the blood-containing vasculature

Answer 10

Congestive Brain Swelling

Question 11

Increased brain tissue water content within the cell and within the intercellular space

Answer 11

Brain Edema

Question 12

4 types of brain edema

Answer 12

Vascular

Cytotoxic

Hypo-osmotic

Hydrostatic

Question 13

3 mechanisms that may operate in the opening of the BBB

Answer 13

Separation of the interendothelial tight junction

Increased vesicular transport and formation of transendothelial channels

Biochemical and structural alteration of the endothelial membrane, resulting in an increase in its permeability

Question 14

Vasogenic edema

Answer 14

vascular leakage (most common edema)

Loss of BBB function

Fluid accumulation between cells

Localized vascular edema - tumor, abscess, hematoma, trauma, infarct

Generalized vascular edema - trauma, toxins

Question 15

Cytotoxic edema

Answer 15

Intracellular fluid accumulation with normal vascular permeability

Damaged ATP-dependent ion pumps

(hypoxia, bacterial endotoxin)

Question 16

Fluid accumulation between the cells

Answer 16

Vasogenic edema

Question 17

Accumulation of fluid within astrocyte

Answer 17

Cytotoxic edema

Question 18

2 examples of hypo-osmotic edema

Answer 18

Water intoxication

Salt toxicity (swine, bovine)

Question 19

Elevated intraventricular hydrostatic pressure that accompanied hydrocephalus

Answer 19

Hydrostatic edema

Question 20

Interstitial edema

Answer 20

Hydrostatic edema

Question 21

Extracellular or intracellular edema of white matter affecting mostly oligodendrocytes

Answer 21

Status spongiosus

Question 22

Vacoulation observed in neurons and processes - affects grey matter

Answer 22

Spongiform changes

Question 23

Reduction of blood flow to a region

Answer 23

Ischemia

Question 24

_ _ are more susceptible than glia or vascular cells

Answer 24

Neurons

Question 25

Most susceptible neurons:

Answer 25

pyramidal cells of layers 3, 5, 6 in cerebral cortex

Hippocampal pyramidal cells

Purkinje cells in cerebellum