an abnormal increase in the number of astrocytes due to the destruction of nearby neurons - a reaction to craniopharyngioma (tumor from rathke pouch)

Path - Intro to Neuro Flashcards by Ahmed Radwan

what is central chromatolysis

nissl removed from the center of the cell to the periphery

seen in the axonal reaction

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intranuclear inclusions should make you think of what conditions

herpes or CMV

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intracytoplasmic inclusions should make you think of what conditions

rabies
alzheimer’s
parkinson
CJD (Creutzfeldt–Jakob disease)

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intracytoplasmic neurofibrillary tangles indicate _____

alzheimer’s

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intracytoplasmic negri bodies indicate _____

rabies

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in what conditions are Alzheimer’s type 2 astrocytes seen

not associated with Alzheimer’s just the same doc named them

hyperammononemia (chronic liver dz)
wilson dz
hereditary metabolic disorder of the urea cycle

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what is astrogliosis

an abnormal increase in the number of astrocytes due to the destruction of nearby neurons

a reaction to craniopharyngioma (tumor from rathke pouch)

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histologic hallmark of astrogliosis

Rosenthal fibers

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in what conditions are Rosenthal fibers seen

reaction to craniopharyngioma (tumor)
long standing gliosis (pilocytic astrocytoma)
Alexander disease

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describe morphology of Rosenthal fibers

thick, elongated, brightly eosinophilic, irregular structures occurring within astrocyte processes

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PAS+ stain should indicate ____

corpora amylacea

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what is corpora amylacea

aging process of cells

increase with age
represents degenerative change

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concentrically laminated, layered onion-looking histological marker indicates ____

corpora amylacea

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CR3 and CD68 markers indicate what cells

microglia (macrophages of the CNS)

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what is neuronophagia

the destruction of nerve cells by phagocytes

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what is progressive multifocal leukoencephalopathy

a progressive demyelinating and usually fatal disease caused by the JC virus that destroys oligodendrocytes in the brain

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what is multiple system atrophy

a fatal neurodegenerative disorder characterized by the abnormal accumulation of toxic forms of the synaptic protein alpha-synuclein (α-syn) within oligodendrocytes and neurons

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compare vasogenic and cytotoxic edema

vasogenic: increase in EXTRAcellular fluid
cytotoxic: increase in INTRAcellular fluid

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what are the pathological causes of hydrocephalus

increased production of CSF
obstruction
decreased absorption of CSF (outflow obstruction)

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what occurs in response to increased CSF

absorption
dilation of frontal and temporal horns
elevation of corpus callosum
thinning of the cerebral mantle
stretching/perforation of the septum pellucidum
enlargement downward of third ventricle
papilledema

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what can cause increased CSF production?

choroid plexus papilloma

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appearance of broccoli (thick fibrous core/stalk) on histo indicates ____

choroid plexus papilloma

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describe pyogenic meningitis

suppurative exudate covering the brainstem and cerebellum –> obstructive hydrocephalus

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causes of acquired hydrocephalus

infections (meningitis)
mass lesions (neoplasms)
inflammation
post-hemorrhage
choroid plexus papilloma
sagittal sinus thrombosus
hypervitaminosis A

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too much vitamin A can lead to what brain condition

acquired hydrocephalus

why is the CSF normal in hydrocephalus ex-vacuo?

because it is a slow process - has time to normalize

the clinical triad of urinary incontinence, gait disturbance, and dementia, indicate what dz process? "wet, wacky, and wobbly)

normal pressure hydrocephalus

effects of tonsillar herniation

respiratory and cardiac center compression

describe kernohan's notch phenomena

compressor of the cerebellar peduncle against the tentorium cerebella due to a transtentorial herniation --> canes ipsilateral hemiparesis or hemiplegia on the side of the herniation produces a visible "notch" in cerebellar peduncle

compare hypoxia and ischemia

hypoxia: low partial pressure of O2 ischemia: impairment of blood's oxygen carrying capacity, or inhibition of O2 usage

what signs does the Sommer sector of the hippocampus show in hypoxia

shows decreased number of cells

what areas of the brain are first to show signs of hypoxia

purkinje of the cerebellum pyramidal cells of the Sommer's sector of the hippocampus (areas CA1 and CA2)

what signs does the purkinje of the cerebellum show in hypoxia

shrunken, eosinophilic, pyknotic cells "dead red guys"

compare liquefactive and coagulative necrosis

liquefactive: no architectural remnants coagulative: there are architecture remnants

histological hallmark of cerebral infarction

missing neuropil, appears pale, decreased number of cells

what is a hygroma

separation of arachnoid from the dura due to contraction of underlying brain parenchyma s/p infarct

describe myelomeningocele

extension of the CNS tissue through a defect in the vertebral column (most often lumbosacral)

describe meningocele

protrusion of the meninges through a defect in the vertebral column

describe encephalocele

disorganized brain tissue extending through defect in cranium (usually posterior fossa)

describe anencephaly

absence of most of the brain and calvarium, but still have cerebellum and brainstem

in what trimester do encephaloceles and ancecenphaly occur

first trimester

in what trimester do lissencephalia and microgyria occur

second semester

fetal alcohol syndrome, HIV-1, and Zika virus can cause what forebrain anomalies

microcephaly

describe lissencephaly

decreased number of gyro with a smooth or "cobblestone" surface

describe polymicrogyria

small, unusually numerous, irregularly formed convulsions of the gyri

describe neuronal heterotopias what condition are they associated with

collections of neurons in inappropriate places along the pathway of migration associated with epilepsy

describe holoprosencephaly and how it presents clinically

incomplete separation of the cerebral hemispheres across the midline clinical: cyclopia, arrhinenceophaly

what is arrhinenceophaly

absence of olfactory cranial nerves

describe dandy walker malformation

enlarged posterior fossa with expanded, roofless fourth ventricle - cerebellar vermis is absent and replaced by a cyst

describe Joubert syndrome

hypoplasia of the vermis, elongation of cerebellar peduncles and altered brainstem shape "molar tooth sign"

molar tooth sign is indicative of _____

jobbery syndrome

describe syringomyelia and its sx

a fluid filled cleft-like cavity in the inner portion of the spinal cord sx: isolated loss of pain and temp sensation of upper extremities bilaterally

describe hydromyelia

expansion of the ependymal-lined central canal of the cord

where are intraparenchymal hemorrhages seen

in germinal matrix

chalky yellow plaques are indicative of what dz process

periventricular leukomalacia

compare where skull fractures usually occur in an awake patient and in an LOC patient

awake: usually fall backward --> occipital fx LOC: usually fall forward --> frontal impact

sx of basal skull fracture

otorrhea/rhinorrhea from CSF drainage from ear or nose

describe a TBI/CTE

some level of damage to the brain from an external mechanical force - associated diminished or altered state of consciousness - brain function temporarily or permanently impaired

when can CTE (chronic traumatic encephalopathy) be diagnosed?

only when examining brains after death

morphology of CTE (chronic traumatic encephalopathy)

progressive loss of normal brain matter and an abnormal buildup of the protein tau

hyperphosphorylated tau protein as neurofibrillary tangles, astrocytic tangled, and neuritis in striking clusters around small blood vessels of the cortex indicates what dz process

chronic traumatic encephalopathy (CTE)

general features of CTE

- neurofibrillary tangles/amyloid and tau deposition - depigmentation of substantia nigra - cerebral atrophy/enlarged ventricles - micro-hemorrhages/DAD

what would cause a contrecoup parenchymal in jury of the brain

sudden deceleration --> head going forward, so brain hits the skull on the back the brain contacts the skull on the side opposite from where impact occurs

yellowish brown patches involving the crests of the gyro indicate what

plaque jaune | - old trauma lesions

what is diffuse axonal injury

axonal swelling and/or focal hemorrhagic lesions that appear within hours

morphology of diffuse axonal injury

increased number of microglial areas and degeneration of involved tracts

axonal spheroids indicate what dz process

diffuse axonal injury

what microscopic test should be performed to diagnose shaken impact syndrome

microscopic iron to identify old bleeding | - use a Prussian blue stain

trauma in the epidermal space occurs how, what sx, and what type of blood is involved

how: skull fracture sx: rapidly evolving neurologic sx blood: arterial

trauma in the subdural space occurs how, what sx, and what type of blood is involved

how: mild trauma sx: slowly evolving neurologic sx blood: venous