Neuropathology 1

Question 1

Normal Hydrocephalus

• What
• Demo
• Cause
• CS&S
• Tx

Answer 1

• What: Abnormal buildup of CSF (pathological build up of lat ventricles)
• Demo: Most common in elderly
• Causes: Idiopathic or 2ndary to head trauma, infection, tumor, subarachnoid hemorrhage
• CS&S: gait abnormality,cognitive disturbance, urinary incontinence
• Tx: large volume lumbar puncture or shunt placement

Question 2

Apraxia

- Ex

Answer 2

Inability to perform a skilled or learned act correctly
Individual has ability and will to perform

Ex:

• Shuffled gait
• Can walk N gait laying down. Can’t actually perform

Question 3

Risk factors for stroke

Answer 3

HBP
Diabetes
Heart disease
Smoking
Age
Gender
Race and ethnicity
Family hx
Brain aneurysms
Ateriovenous malformations (AVMs)

Question 4

S&S of stroke and TIA

Answer 4

S&S:
sudden weakness
*Worst Sudden headache*
Paralysis
Diff speaking
Diff breathing
Lack of coordination
Diff seeing
Confusion

Question 5

Tx for stroke

Answer 5

• Clot-busting medication (tPA): 4 hr time window
• Antiplatelet
• Anticoagulation

Question 6

Subfacine/ cingulate herniation

• Location
• Arteries/veins

Answer 6

• Location: Mass effect in supratentorial compartment (forces cingulate gyrus against or under falx cerecri)
• Frequent in parietal and frontal/parietal areas
• Arteries/veins: ACA on SS/OS or both sides of mass.
  internal cerebral veins: venous stasis, edema, venous infarcts
• CS&S: M1 and S1 of LE, inc ICP, alterations in behavior

Question 7

Uncal herniation/ downward transtentorial herniation

• Etiology
• Location
• CS&S (initial and progressive)

Answer 7

• Etiology: Hematoma, tumor, infarcation w/ resulting edema in temp lobe
• Location: Uncus and parahippocampal gyrus are displaced over edge of tentorium cerebelli (Compresses midbrain)
• CS&S:
• Initial: pupil dilated and slow response, pt responds appropiately to noxious stimulus
• Progression: Hyperventilation, most eye movement absent, visual defects, muscle weakness on contralat side, dec lvl of consciousness

Question 8

Diencephalic herniation

• Location
• CS&S:
• (initial and progression)

Answer 8

• Expanding mass in P,O,T lobes or expanding mass in basal nuclei, internal capsule, lat thalamus
• CS&S: mucles hypertrophy, diabetes insipidus, small pupils (responsive), dec in consciousness
  Initital: occasional yawning
  Progression: Cheyne-Strokes respiration, doll’s eyes

Question 9

Transtentorial herniation (central henriation)
- Artery

Answer 9

• High p. in supratentorial compartment. Displaces brain tissue downward through tentorial notch (compromises midbrain, pons, medulla)
• CS&S: respiratory problems (Cheyen-Strokes) tachypnea, pupils are irregular in shape, fixed and irregular pupils and dilated
• May compress PCA (visual field loss)

Question 10

Glial cell tumor
CSS
Tx

Answer 10

CSS: Repetitive unexplained headaches, seizure (uncommon)

Tx:
Surgical removal: limited due to astrocyte shape
Radiation therapy: limited due to lectin in glial cells
Chemotherapy: limited due to lectin in glial cells
Steriods: Dec immune response, alter hormonal lvls
*Usually combination of 1 or more

Question 11

Glioblastoma Multiforme

Answer 11

Most common and most deadly
55%
Astrocytic in nature