Neuropathology - Vascular

Question 1

What kind of processes can cause CNS damage?

Answer 1

trauma 
hypoxia 
toxic insult 
metabolic abnormalities 
nutritional deficiencies 
infections 
ageing 
genetics

Question 2

What is axonal reaction?

Answer 2

a reaction within the cell body that is associated with axonal injury

Question 3

What process are astrocytes involved in that cause proliferation?

Answer 3

gliosis

Question 4

What is gliosis?

Answer 4

astrocytes undergo hyperplasia and hypertrophy
nucleus enlarges, becomes vesicular and the nucleolus is prominent
cytoplasmic expansion with extension of processes

Question 5

What does gliosis indicate?

Answer 5

CNS injury regardless of cause

Question 6

What is the function of oligodendrocytes

Answer 6

produce myelin in the CNS

Question 7

What kind of disorders damage oligodendrocytes?

Answer 7

demyelinating conditions

Question 8

What are ependymal cells?

Answer 8

cells which line the ventricular system and form arachnoid graduations

Question 9

What are microglia?

Answer 9

CNS macrophages and antigen presenting cells

Question 10

How to microglia respond to injury?

Answer 10

proliferation
develop rod cells
form aggregates
congregate around dying neurones

Question 11

What areas of the brain are supplied by the vertibrobasilar arteries?

Answer 11

brain stem
cerebellum
occipital lobe

Question 12

What visual deficit is seen in occipital lobe damage?

Answer 12

homonymous hemianopia with macular sparing?

Question 13

What cardinal signs are seen in cerebellar disease?

Answer 13

ataxia
nystagmus
intention tremor
pendular reflexes

Question 14

What areas of the brain are first to be damaged in ischaemia?

Answer 14

watershed areas - boundaries of arterial territories where supply is reduced first

Question 15

What is a stroke?

Answer 15

a sudden onset neurological deficit that lasts for more than 24 hours or causes death

Question 16

What can strokes be classified into acutely?

Answer 16

complete strokes
evolving strokes
TIA

Question 17

What percentage of strokes are ischaemic?

Answer 17

85%

Question 18

What is the most common cause of cerebral infarction?

Answer 18

thrombosis/emboli

Question 19

What are some stroke risk factors?

Answer 19

age 
hypertension 
AF 
hyperlipidaemia 
obesity 
IHD 
diabetes 
smoking 
carotid stenosis

Question 20

At what time will ischamic changes begin to develop on brain imaging?

Answer 20

15-20 hours

Question 21

At what point will a necrotic area become visible macroscopically and become swollen and softer?

Answer 21

36-48 hours

Question 22

At what point will macrophages begin to infiltrate into the area

Answer 22

day 3

Question 23

At what point will liquefaction and gliosis be seen in the brain after a stroke?

Answer 23

1-2 weeks

Question 24

What brain changes will be seen months after the insult?

Answer 24

cavitation and completion of glial scar

Question 25

What is the most common cause of SAH?

Answer 25

Berry aneurysm

Question 26

What type of infarcts are caused by hypertension in the brain?

Answer 26

lacunar infarcts

Question 27

What condition is preceded by hypertension and multiple small brain infarcts over time?

Answer 27

multi-infarct dementia

Question 28

Where is the most common site of a Berry aneurysm?

Answer 28

arterial bifurcation of the internal carotid artery.