Path II Flashcards
common cause of alzheimer type II astrocytes
hepatic encephalopathy
when does irreversible injury occur in neurons in hypoxic or ischemic conditions
5-10 minutes
red neurons appear when
12-24 hours after death
most important histopathologic indicator of chronic CNs injury
gliosis
gliosis
astrocyte hyperplasia and hypertrophy
asctrocytes have GFAP
what lines central canal
ependyma
what supplies blood to the choroid plexus
choroidal branches of internal carotid and basilar aa
what is blood supply to choroid plexus in 4th ventricle
PICA
majoirty CSF produced where
in the lateral ventricles
movement of CSF is controlled by
pulstaion of aa
aid of cilia and microvilli of ependymal cells
factors that facilitate flow of CSF in subarachnoid space
pulsation of cerebral and spinal aa
movements of the vertebral column
respiration and coughing
changing of positions
what aa is implicated in epidural bleeds
middle meningeal from the anterior cerebral
epidural space is between what layers
calvaria and periosteal layer dura
subdural layer
between meningeal dura and arachnoid mater
subarachnoid space
not real space
between arachnoid and pia mater
what type of brain bleed can cause blood in lumbar puncture
sub arachnoid because blood can get into the CSF
what controls CSF P
the rate of absorption of CSF by the arachnoid granulations
what is virchow robbins space
space that surrounds vessels in brain except end at level of capillaries
what happens when inflammatory cells get into virchow robbins soace
BB altered secondary to inflammation and the brain parenchyma becomes edematous with neutrophils
what can cause blood in CSF
accidental puncture of leptomeningeal vein when doing puncture
subarachnoid hemoorhage
how is CSF evaluated for blood
do many tubes consecutive and see if blood clears. if it doesn’t then probably subarachonid hemorrhage and not puncture of a during lumbar puncture
what causes the blonde color or xatnthochromia of CSF after subarachnoid bleed
oxyhemoglobin which apperas in 4-6 hrs and bilirubin
what else can cause xanthocrhomia of CSF
hemorrhagic infarcts, brain tumors and jaundice
causes of bloody CSF
SAH
Intracerebral hemorrhage
cerebral infarct
traumatic spinal tap
brown xanthocrhomia
meningeal mets melanoma
hemosiderin laden macrophages in CSF
from SAH
what can cause increased CSF neutrophils
meningitis other infections cerebral abscess, AIDS related CMV after seizure after CNS hemorrhage CNS infarct repeated lumbar puncture injection foreign material in subarachnoid space mets
what can cause increase CSF lymphocytosis
meningitis usually viral degenerative disorders MS, Drug abuse encephalopathy guillain barre! other inflammatory disorders
tumor cells in CSF
ALL
blast cells with scant blue cytoplasm
fine chromatin and 1-2 nuclei
most common cancers mets to brain
carcinomas
CSF rinorrhea
badness!
disrupted barrier between sinonasal cavity and ant/middle cranial fossa
can cause infections!! to brain!
beta 2 transferrin
located in CSF, perilymph and aqueous humor
single best lab test to detect CSF in sinonasal fluid
beta 2 transferrin
spontaneous CSF rinorrhea
secondary to an intracranial process, like elvated intracranial P
what is encephalocele
when brain parenchyma herniates through a defect
double ring sign
CSF
what are the rings of CSF
internal is blood and outer is CSF
localization of leak of CSF
inject intrathecal fluorescein to locate
primary tumors assoc with ventricles
choroid plexus papilloma
ependymoma
choroid plexus carcinoma (rare)
choroid plexus papilloma presentation
rare
increased CSF can lead to hydrocephalus or an obstruction too
choroid plexus papilloma location children vs adults
lateral ventricle in children
4th ventricle in adults
age of ependymoma
children and adolescents
location of ependymoma
4th ventricle
block cSF and cause hydrocephalus
rossettes and pseudorosettes
ependymoma
