Robbins Overview Flashcards
Repair cells of the brain - gliosis
fibers?
Astrocytes
Rosenthal fibers
2 types of cerebral edema
Vasogenic - disruption of BBB (local or generalized)
Cytotoxic - increased intracellular fluid - toxic/ hypoxic
2 kinds of hydrocephalus
non-communicating: mass usually obstructs foramen of Monroe or cerebral aqueduct
communicating: decreased reabsorption of CSF thru subarachnoid villi
Subfalcine herniation:
gyrus involved?
artery invovled?
Subfalcine:
cingulate
ACA (lower limbs)
Transtentorial herniation
gyrus?
nerve?
artery?
Transtentorial:
Temporal lobe - uncus
CN III (diplopia, ptosis, pupillary dilation (blown pupil))
PCA, which supplies the primary visual cortex
Most Berry aneurisms
(note: loss of muscular wall and internal lamina, lined only by hyalinized intima)
Can result in SAH
Anterior Circulation - ACA at the junction of ACOMM (40%), 34% at MCA
Atherosclerotic aneurisms occur where?
basilar artery
non-sacular aneurisms cause damage by?
vascular occlusion
Charcot-Bouchard microaneurism due to HTN
most commonly affects?
Can result in?
Basal Ganglia > Thalamus > Cerebellum > Pons
“Bulges that can pop”
ICH
Agenesis of cerebellar vermis
Dandy Walker
viral a/w microglial nodules
HIV encephlopathy
Progressive Multifocal leukencephalopathy (PML) caused by what virus which infects what cells?
JC virus (Polyomavirus), oligodendrocytes progressive neuro signs ring enhancing lesions on CT hemispheric or cerebellar white matter Immunocompromised patients
Only fungus known to invade the brain directly thru the cribiform plate
a/w DM
Mucor
CJD vs. vCGD
Creuzfeldt-Jakob
CGD - rapid onset, death in 7 months; spongiform changes in cerebral cortex and deep grey matter, no inflammation
vCGD - 1995, bovine spongiform encephalopthy ++Amyloid plaques
Adult tumor location vs. childhood tumor location
Adults - supratentorial
Children - posterior fossa
Childhood tumor: pilocytic astrocytoma is most commonly found in the cerebellum; cystic part and solid part GFAP+ contains Rosenthal fibers BRAF mutation means? V600E mutation means?
BRAF - cerebellar location
V600E - extracerebellar (if it involves the hypothalamus, it is harder to resect)
In adults, this tumor is found in the spinal cord, a/w NF-2
Ependymoma
Pathology of ependymoma
perivascular pseudo-rosettes
Blapharoplasts near the nucleus
Pathology of oligodendrocytomas
Chicken wire capillaries
fried egg cytoplasm
Calcifications
Primitive neuroectodermal tumor (PNET) children - cerebellum
Myc - poor progonosis
Wnt - good prognosis
Highly malignant, can send drop mets to spinal cord
Medulloblastoma
most common CNS neoplasm in immunocompromised pt a/w EBV
large B cells
CNS lymphoma
often present w/ seizures or focal signs; arise from arachnoid cells; when there are multiple or a CNVIII shwannoma is present, consider NF2
spindle cells in a whirled pattern Psommoma bodies (lamellated calcifications)
Meningioma
