Neuropathology 1: Trauma, Demyelination, Neurodegenerative Diseases Flashcards

1
Q

What are the mechanims of head injury

A

Primary events

Secondary events

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2
Q

What are primary events

A

Immediate consequences which are:

  • neural
  • vascular
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3
Q

What are secondary events:

A
  • ischaemia
  • raised intracranial pressure
  • infection
  • post traumatic epilepsy
  • chronic traumatic encephalopathy
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4
Q

What are the types of neural damage

A

Contusional damage
Traumatic axonal injury
Diffuse axonal injury

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5
Q

What are contusional damage

A
Focal symptoms 
contre coup injury
Common in frontol and temporal lobes 
Burst lobe 
Post traumatic epilepsy
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6
Q

What is the contre coup injury

A

This is when there is injury that occurs at the site of impact , the brain move to the other side and has another injury at the other side.

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7
Q

Why are contusional damage common in the frontol and temporal lobe

A

Temporal and frontol lobes are the largest lobes so are exposed more

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8
Q

What is a burst lobe

A

When there is a large intra cerebral haemorrhage which is big that causes a burst

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9
Q

What is traumatix axonal injury

A

The brain is not hurt by a large haemorrhage, the axons are however stretched or disrupted

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10
Q

Give an example of a severe form of traumatic axonal injury

A

Diffuse axonal injury

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11
Q

What is diffuse axonal injury

A

Axons are damaged due to large velocity acceleration

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12
Q

Is diffuse axonal injury compatible with life

A

No

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13
Q

What state does axonal diffuse injury cause

A

Post traumatic persistent vegetative state

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14
Q

What are the types of vascular damage

A
  1. Diffuse vascualr damage
  2. Damage to arteries in neck or intracrainally causing infarction or ischaemia
  3. Intracranial haemorrhage
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15
Q

What are the 4 types of haemorrhage

A
  1. Extrdural
  2. Subdural
  3. Subarachnoid
  4. Intracerebral
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16
Q

What is a extradural haemorrhage

A

Usually arterial

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17
Q

What is a subdural haemorrhage

A

Damage to underyling or briding veins

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18
Q

What are the risk factors for subdural haemorrhage

A

Anticoagulation therapy
Alcoholism
Cerebral atrophy seen in elderly

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19
Q

What is subarachnoid haemorrhage

A

Damage to vertebral arteries in the neck or shearing of intracranial arteries

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20
Q

What is a intracerebral haemorrhage

A

From the contusion that may occurs hours/days after injury

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21
Q

When is raised intracranial pressure seen

A

In the form of cerebral oedema

22
Q

What can the cerebral oedema be a reaction to

A

Haematoma

23
Q

What effect would a haematoma have

A

Mass effect which can raise the pressure

24
Q

Name an example of infection that can occur

A

Meningits

25
Q

What can meningits form due to

A

Compound depressed fracture of the skull

Fracutre of the base of skull through the air siunuses and middle ear

26
Q

What is post traumatic epilepsy

A

Recurrent seizure that results fom injury to the brain

27
Q

What is chronic trauma encephalopathy

A

Brain degeneration caused by repeated head trauma

28
Q

What is a common sport that can cause chronic trauma encephalopathy

A

Boxing

29
Q

What are the causes of dementia

A
Neurodegenerative disease
Vascular disease 
Alcohol 
Hydrocephalus 
Metabolic, hepatic, thryoid disease, b12 deficiency 
Cerebral tumours 
Autoimmune limbic encephalitis 
Mutliple sclerosis 
Infections: hiv, herpes
30
Q

What are the commonest causes of dementia

A

Alzheimer’s disease
Vascular dementia
Lewy body dementia
Frontotemporal dementia

31
Q

What is Alzheimer’s disease

A

Cerebral atropgy of the frontol and temporal lobes and reduced dendritic branches of neurones

32
Q

What are the other features in the brain in Alzheimer’s disease

A

Neurotic (amyloid) plaques
Neurofibrillay tangles
Amyloid angiopathy

33
Q

What are the risk factors for Alzheimer’s disease

A

Age
Head injury
Down syndrome
Mutation in BAPP genes

34
Q

What is the therapy in Alzheimer’s disease

A

Anticholinergic agents

Immunisation against amyloid beta peptide to reduce plaques

35
Q

What is lewy body disorder

A

This is an umbrella term for 2 diseases of:
Lewy body dementia
Parkinsons disease dementia

36
Q

What happens in parkisons disease dementia

A

There is loss of pigmented cell in the substantia niagra and there is lewy bodies in the substantia niagra which leads to loss of dopaminergic input to the basal ganglia

37
Q

What is lewy body dementia

A

There are lewy bodies in the cytoplasm of cortical neruones

38
Q

What is vascular dementia

A

Mutli infarct dementia i.e accumulation of infarcts that leads to dementia

39
Q

What is fronto temporal dementia

A

This is a group of disorders that cocur when the nerve cells in the frontol and temporal loves of the brian are lost

40
Q

What are the common types of fronto temporal dementia

A

Behavioural variant

Primary progressive aphasia

41
Q

What are the subtypes of primary progressive aphasia

A

Non fluent variant

Semantic variant

42
Q

What is non fluent variant of primary progressive aphasia

A

With language deficits

43
Q

What is the semantic variant of primary progressive aphasia

A

Deficit with ability to use and understand language

44
Q

What is the behavioral variant

A

Deterioration in personality and behaviour

45
Q

What are the form of motor neurone disease

A

Primary lateral sclerosis- only affects upper motor neurone
Progressive muscular atropgy- onyl affects the lower motor neurone
Progressive bulbar palsy

46
Q

What is the pathology of motor neurone disease

A

Ubiquitinated inclusions in more neurone nuecloi

47
Q

What is prion disorder

A

Mainyl characterised by creutzfeldt jakob disease

48
Q

What is the pathology of prion disorders

A

Spongiform change with neuronal loss, gliosis and amyloid plaques mostly in the cerebellum and the cerebral cortex

49
Q

What is multiple sclerosis

A

Demyelination of axons with relative axonal preservation and affects the optic nerves, periventricular white matter, cerebellum, brainstem and spinal cord

50
Q

What is the pathology of MS

A

T cell mediatd immune response to myelin antigens