Robbins Overview

Question 1

Repair cells of the brain - gliosis

fibers?

Answer 1

Astrocytes

Rosenthal fibers

Question 2

2 types of cerebral edema

Answer 2

Vasogenic - disruption of BBB (local or generalized)

Cytotoxic - increased intracellular fluid - toxic/ hypoxic

Question 3

2 kinds of hydrocephalus

Answer 3

non-communicating: mass usually obstructs foramen of Monroe or cerebral aqueduct

communicating: decreased reabsorption of CSF thru subarachnoid villi

Question 4

Subfalcine herniation:
gyrus involved?
artery invovled?

Answer 4

Subfalcine:
cingulate
ACA (lower limbs)

Question 5

Transtentorial herniation
gyrus?
nerve?
artery?

Answer 5

Transtentorial:
Temporal lobe - uncus
CN III (diplopia, ptosis, pupillary dilation (blown pupil))
PCA, which supplies the primary visual cortex

Question 6

Most Berry aneurisms
(note: loss of muscular wall and internal lamina, lined only by hyalinized intima)
Can result in SAH

Answer 6

Anterior Circulation - ACA at the junction of ACOMM (40%), 34% at MCA

Question 7

Atherosclerotic aneurisms occur where?

Answer 7

basilar artery

Question 8

non-sacular aneurisms cause damage by?

Answer 8

vascular occlusion

Question 9

Charcot-Bouchard microaneurism due to HTN
most commonly affects?
Can result in?

Answer 9

Basal Ganglia > Thalamus > Cerebellum > Pons
“Bulges that can pop”

ICH

Question 10

Agenesis of cerebellar vermis

Answer 10

Dandy Walker

Question 11

viral a/w microglial nodules

Answer 11

HIV encephlopathy

Question 12

Progressive Multifocal leukencephalopathy (PML) caused by what virus which infects what cells?

Answer 12

JC virus (Polyomavirus), oligodendrocytes
progressive neuro signs 
ring enhancing lesions on CT 
hemispheric or cerebellar white matter 
Immunocompromised patients

Question 13

Only fungus known to invade the brain directly thru the cribiform plate
a/w DM

Answer 13

Mucor

Question 14

CJD vs. vCGD

Creuzfeldt-Jakob

Answer 14

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

Question 15

Adult tumor location vs. childhood tumor location

Answer 15

Adults - supratentorial

Children - posterior fossa

Question 16

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?

Answer 16

BRAF - cerebellar location

V600E - extracerebellar (if it involves the hypothalamus, it is harder to resect)

Question 17

In adults, this tumor is found in the spinal cord, a/w NF-2

Answer 17

Ependymoma

Question 18

Pathology of ependymoma

Answer 18

perivascular pseudo-rosettes

Blapharoplasts near the nucleus

Question 19

Pathology of oligodendrocytomas

Answer 19

Chicken wire capillaries
fried egg cytoplasm
Calcifications

Question 20

Primitive neuroectodermal tumor (PNET) children - cerebellum
Myc - poor progonosis
Wnt - good prognosis
Highly malignant, can send drop mets to spinal cord

Answer 20

Medulloblastoma

Question 21

most common CNS neoplasm in immunocompromised pt a/w EBV

large B cells

Answer 21

CNS lymphoma

Question 22

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)

Answer 22

Meningioma