Neuropathology 2: Vascular Disease And Tumours

Question 1

What are the 3 types of hernias increased intracranial pressure can cause

Answer 1

1. Subfalcine herniation
2. Uncal herniation
3. Tonisllar herniation

Question 2

What is subfalcine herniation

Answer 2

When a cingulate gyrus or frontol lobe herniates under the falx cerebri

Question 3

What is uncal herniation

Answer 3

When the medial temporal gyrys goes underneath the tentorium cerebelli

Question 4

What is tonsillar hernaition

Answer 4

When the tonsils of the cerebellum goes to the foramen magnum

Question 5

What are the complications of subfalcine herniation

Answer 5

Bleeding in the territory supplied by the anterioir cerebral artery

Question 6

What are the complications of uncal herniation

Answer 6

• 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

Question 7

What is stroke

Answer 7

A cerebrovascular accident which has a abrupt onsent of neurological deficit due to a vascular disease

Question 8

What are the 2 classification of stroke

Answer 8

1. Ischaemic stroke: thrombi or emboli

2. Haemorrhagic stroke: bleeding

Question 9

What type of blood pressure can cause a stroke

Answer 9

Hypotension

Hypertension

Question 10

What is the difference between ischaemia or stroke

Answer 10

Ischaemia: reduced blood flow which results in hypoxia of the tissue
Infarction: complete blood flow cut off resulting in necrosis/cell death

Question 11

Which cells in the brain are vulnerable to ischaemia

Answer 11

Neurones

Question 12

Which regions in the hippocampus are vulnerabel regions to hypoxic changes

Answer 12

Ca1
Ca3
Ca4

Question 13

What can cause infarction

Answer 13

Thrombi

Emboli

Question 14

What type of infarct is thrombotic infarction

Answer 14

Pale

Question 15

What type of infarction is embolic infarction

Answer 15

Red

Question 16

What the risk factors for atherosclerosis

Answer 16

Smoking
Hypertension
Diabetes
Hyperlipidemia
Increased age 
Male

Question 17

What are the commonest cause of haemorrhage

Answer 17

Hypertension

Amyloid angiopathy

Question 18

What is a subarachnoid haemorrhage

Answer 18

Bleed in the subarachnoid compartment (under the pia mater)

Question 19

Causes of subarachnoid haemorrhage

Answer 19

Aneurysm in the middle cerebral artery, anterior communication artery, basilar artery, cerebellar arteries, internal carotid artery

Question 20

What is a epidural haemorrhage

Answer 20

Convex shaped haemorrhage

Question 21

Commonest cause of epidural haemorrhage

Answer 21

Middle meningeal artery rupture

Question 22

What are subdural haemorrhage

Answer 22

Haemmorhage that occur under the dura and are cruciate shaped

Question 23

What is the commonest cause of subdural haemorrhage

Answer 23

Rupture of the bridging veins

Question 24

What are the common brain metasise primary tumours

Answer 24

Lung
Breast
Skin
Kidney

Question 25

What are the most common brain tumours in adults

Answer 25

Glioblastoma Schwannoma Neurofibroma Meningioma

Question 26

What are the common tumours in children

Answer 26

Pilocytic astrocytoma Ependymoma Medullablastoma

Question 27

What is oligodendroglioma

Answer 27

Diffuse glial tumours in adults

Question 28

What are the microscope features of oligodendroglioma

Answer 28

Regular branching capillary network with round and clear cells Idh mutation and 1p,19q deletion

Question 29

What are ependymoma

Answer 29

Tumours in the spinal cord or outside the spinal cord seen in children

Question 30

What are meningiomas

Answer 30

Mesenchymal tumours that arise in the dura outside the brain

Question 31

What are peripheral nerve sheath tumour examples

Answer 31

Neurofibroma: tumour grows within the nerve Schwannoma: tumour grows outside the nerve

Question 32

What are the types of spinal tumours

Answer 32

1. Intradural, intramedullary i.e within the dura and within the medulla of the spinal cord 2. Intradrual, extramedullary. I.e within the duyra and outside the spinal cord 3. Extradural i.e outside the dura and outside the spinal cord

Question 33

Examle of a intradural, intramedullary spinal tumour

Answer 33

Astrocytoma | Ependymoma

Question 34

Example of a intradural, extramedullary spinal tumour

Answer 34

Meningioma | Scwannoma

Question 35

Example of extradural spinal tumor

Answer 35

Metastatic carcinoma | Lymphoma

Question 36

What are the common infections of the cns

Answer 36

``` Bacterial meningitis Cerebral abscess Chronic meningitis Viral encephalitis Encephalomyelitis Subacute sclerosing panencephaliits Post infectious encephalomyelitis ```

Question 37

What are the routes of infection of bacterial meningitis

Answer 37

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

Question 38

How do we diagnose meningitis

Answer 38

Csf analysis

Question 39

What are the complications of bacterial meningits

Answer 39

Cerebral swelling Infective thrombophlebitis Subdural effusions Hydrocephalus

Question 40

What are the route of infection of cerebral abscess

Answer 40

Haemogemous: spread from purulent chronic infection e.g lung abscess Local spread

Question 41

What is the pathology of cerebral abscess

Answer 41

Cerebritis with cavitation and pus formation, encapsulated by gliosis an granulation tissue

Question 42

What is chronic meningitis

Answer 42

When pus collects at base of the brain over weeks

Question 43

What are the causes of chronic meningitis

Answer 43

Tuberculosos Cytococcal (fungi) Inadequately treated bacterial meningitis

Question 44

What are the causes of viral encephalitis

Answer 44

Hsv1 Hsv2 Arbovirus

Question 45

What is the cause of rabies

Answer 45

Rhabdovirus: bite from an animal

Question 46

What is the diagnosis of rabies

Answer 46

Rabied negritude bodies

Question 47

What is encephalomyelitis

Answer 47

Inflammation of the brain and spinal cord

Question 48

What are the causes of encephalomyelitis

Answer 48

Poliovirus 1,2,3

Question 49

What is subacture sclerosing panencephalitis

Answer 49

Slow viral infection usually seen secondary to measles

Question 50

What is post infectious encephalomyelitis

Answer 50

Secondary to infection such as measles, varicella, rubella and mumps