Neuropathology - Vascular Flashcards
What kind of processes can cause CNS damage?
trauma hypoxia toxic insult metabolic abnormalities nutritional deficiencies infections ageing genetics
What is axonal reaction?
a reaction within the cell body that is associated with axonal injury
What process are astrocytes involved in that cause proliferation?
gliosis
What is gliosis?
astrocytes undergo hyperplasia and hypertrophy
nucleus enlarges, becomes vesicular and the nucleolus is prominent
cytoplasmic expansion with extension of processes
What does gliosis indicate?
CNS injury regardless of cause
What is the function of oligodendrocytes
produce myelin in the CNS
What kind of disorders damage oligodendrocytes?
demyelinating conditions
What are ependymal cells?
cells which line the ventricular system and form arachnoid graduations
What are microglia?
CNS macrophages and antigen presenting cells
How to microglia respond to injury?
proliferation
develop rod cells
form aggregates
congregate around dying neurones
What areas of the brain are supplied by the vertibrobasilar arteries?
brain stem
cerebellum
occipital lobe
What visual deficit is seen in occipital lobe damage?
homonymous hemianopia with macular sparing?
What cardinal signs are seen in cerebellar disease?
ataxia
nystagmus
intention tremor
pendular reflexes
What areas of the brain are first to be damaged in ischaemia?
watershed areas - boundaries of arterial territories where supply is reduced first
What is a stroke?
a sudden onset neurological deficit that lasts for more than 24 hours or causes death
What can strokes be classified into acutely?
complete strokes
evolving strokes
TIA
What percentage of strokes are ischaemic?
85%
What is the most common cause of cerebral infarction?
thrombosis/emboli
What are some stroke risk factors?
age hypertension AF hyperlipidaemia obesity IHD diabetes smoking carotid stenosis
At what time will ischamic changes begin to develop on brain imaging?
15-20 hours
At what point will a necrotic area become visible macroscopically and become swollen and softer?
36-48 hours
At what point will macrophages begin to infiltrate into the area
day 3
At what point will liquefaction and gliosis be seen in the brain after a stroke?
1-2 weeks
What brain changes will be seen months after the insult?
cavitation and completion of glial scar
What is the most common cause of SAH?
Berry aneurysm
What type of infarcts are caused by hypertension in the brain?
lacunar infarcts
What condition is preceded by hypertension and multiple small brain infarcts over time?
multi-infarct dementia
Where is the most common site of a Berry aneurysm?
arterial bifurcation of the internal carotid artery.
