Neuropathology 2: Vascular Disease And Tumours Flashcards
What are the 3 types of hernias increased intracranial pressure can cause
- Subfalcine herniation
- Uncal herniation
- Tonisllar herniation
What is subfalcine herniation
When a cingulate gyrus or frontol lobe herniates under the falx cerebri
What is uncal herniation
When the medial temporal gyrys goes underneath the tentorium cerebelli
What is tonsillar hernaition
When the tonsils of the cerebellum goes to the foramen magnum
What are the complications of subfalcine herniation
Bleeding in the territory supplied by the anterioir cerebral artery
What are the complications of uncal herniation
- Third cranial nerve (occulomotor) compression to give fixed dialted pupils
- posterior cerebral artery compression whcih supplies the occipitla cortex so you can get haemorrhagic infarction and can casue blindless
- crus cerebri compression so corticosponal tract (descending) is compressed leads to hemiplegia on the opposite side
What is stroke
A cerebrovascular accident which has a abrupt onsent of neurological deficit due to a vascular disease
What are the 2 classification of stroke
- Ischaemic stroke: thrombi or emboli
2. Haemorrhagic stroke: bleeding
What type of blood pressure can cause a stroke
Hypotension
Hypertension
What is the difference between ischaemia or stroke
Ischaemia: reduced blood flow which results in hypoxia of the tissue
Infarction: complete blood flow cut off resulting in necrosis/cell death
Which cells in the brain are vulnerable to ischaemia
Neurones
Which regions in the hippocampus are vulnerabel regions to hypoxic changes
Ca1
Ca3
Ca4
What can cause infarction
Thrombi
Emboli
What type of infarct is thrombotic infarction
Pale
What type of infarction is embolic infarction
Red
What the risk factors for atherosclerosis
Smoking Hypertension Diabetes Hyperlipidemia Increased age Male
What are the commonest cause of haemorrhage
Hypertension
Amyloid angiopathy
What is a subarachnoid haemorrhage
Bleed in the subarachnoid compartment (under the pia mater)
Causes of subarachnoid haemorrhage
Aneurysm in the middle cerebral artery, anterior communication artery, basilar artery, cerebellar arteries, internal carotid artery
What is a epidural haemorrhage
Convex shaped haemorrhage
Commonest cause of epidural haemorrhage
Middle meningeal artery rupture
What are subdural haemorrhage
Haemmorhage that occur under the dura and are cruciate shaped
What is the commonest cause of subdural haemorrhage
Rupture of the bridging veins
What are the common brain metasise primary tumours
Lung
Breast
Skin
Kidney
What are the most common brain tumours in adults
Glioblastoma
Schwannoma
Neurofibroma
Meningioma
What are the common tumours in children
Pilocytic astrocytoma
Ependymoma
Medullablastoma
What is oligodendroglioma
Diffuse glial tumours in adults
What are the microscope features of oligodendroglioma
Regular branching capillary network with round and clear cells
Idh mutation and 1p,19q deletion
What are ependymoma
Tumours in the spinal cord or outside the spinal cord seen in children
What are meningiomas
Mesenchymal tumours that arise in the dura outside the brain
What are peripheral nerve sheath tumour examples
Neurofibroma: tumour grows within the nerve
Schwannoma: tumour grows outside the nerve
What are the types of spinal tumours
- Intradural, intramedullary i.e within the dura and within the medulla of the spinal cord
- Intradrual, extramedullary. I.e within the duyra and outside the spinal cord
- Extradural i.e outside the dura and outside the spinal cord
Examle of a intradural, intramedullary spinal tumour
Astrocytoma
Ependymoma
Example of a intradural, extramedullary spinal tumour
Meningioma
Scwannoma
Example of extradural spinal tumor
Metastatic carcinoma
Lymphoma
What are the common infections of the cns
Bacterial meningitis Cerebral abscess Chronic meningitis Viral encephalitis Encephalomyelitis Subacute sclerosing panencephaliits Post infectious encephalomyelitis
What are the routes of infection of bacterial meningitis
Blood
Lcoal extension e.g middle ear or air siunues
Direct implantation: if patient has a malformation e.g encephalopathy
Pns: extension from peripheral nrves
How do we diagnose meningitis
Csf analysis
What are the complications of bacterial meningits
Cerebral swelling
Infective thrombophlebitis
Subdural effusions
Hydrocephalus
What are the route of infection of cerebral abscess
Haemogemous: spread from purulent chronic infection e.g lung abscess
Local spread
What is the pathology of cerebral abscess
Cerebritis with cavitation and pus formation, encapsulated by gliosis an granulation tissue
What is chronic meningitis
When pus collects at base of the brain over weeks
What are the causes of chronic meningitis
Tuberculosos
Cytococcal (fungi)
Inadequately treated bacterial meningitis
What are the causes of viral encephalitis
Hsv1
Hsv2
Arbovirus
What is the cause of rabies
Rhabdovirus: bite from an animal
What is the diagnosis of rabies
Rabied negritude bodies
What is encephalomyelitis
Inflammation of the brain and spinal cord
What are the causes of encephalomyelitis
Poliovirus 1,2,3
What is subacture sclerosing panencephalitis
Slow viral infection usually seen secondary to measles
What is post infectious encephalomyelitis
Secondary to infection such as measles, varicella, rubella and mumps
