Summaries Chapter 23: Central Nervous System

Question 1

What is cerebral edema?

Answer 1

Cerebral edema is the accumulation of excess fluid within the brain parenchyma. Hydrocephalus is defined as an increase in CSF volume within all or part of the ventricular system.

Question 2

Increases in brain volume raise the pressure inside the fixed capacity of the skull. What can this increase be a result of?

Answer 2

Ss a result of increased CSF volume, edema, hemorrhage, or tumor

Question 3

True/false: Malformations of the brain can occur because of genetic factors or external insults.

Answer 3

True

Question 4

Various malformations stem from …

Answer 4

failure of neural tube closure, improper formation of neural structures, and altered neuronal migration.

Question 5

Perinatal brain injury mostly takes one of two forms. Which two?

Answer 5

(1) hem- orrhage, often in the region of the germinal matrix with the risk for extension into the ventricular system; and (2) ischemic infarcts, leading to periventricular leukomalacia.

Question 6

Certain infections may affect the brain during development with …

Answer 6

subsequent tissue destruction and neurologic consequences.

Question 7

True/false: Only viruses can infect the brain

Answer 7

False, pathogens from viruses through parasites can infect the brain

Question 8

What is prion disease?

Answer 8

a protein-induced transmissible disease that is unique to the nervous system

Question 9

True/false: regardless of the pathogen, all infections cause similar patterns of disease in the brain

Answer 9

False, different pathogens use distinct routes to reach the brain, and they cause different patterns of disease.

Question 10

What may bacterial infections cause in the brain?

Answer 10

Meningitis, cerebral abscesses, or a chronic meningoencephalitis

Question 11

What may viral infections cause in the brain?

Answer 11

Meningitis or meningoencephalitis

Question 12

HIV can directly and indirectly affect the brain. Explain the two mechanisms

Answer 12

HIV can directly cause meningoencephalitis, or indirectly affect the brain by increasing the risk for opportunistic infections
(toxoplasmosis, CMV) or CNS lymphoma.

Question 13

True/false: Prion diseases are transmitted by an altered form of a
normal cellular protein. They can be sporadic, transmitted, or inherited.

Answer 13

True

Question 14

Why can diseases of myelin lead to widespread and severe neurologic deficits?

Answer 14

Because of the critical role of myelin in nerve conduction

Question 15

What is Multiple Sclerosis (MS)?

Answer 15

Multiple sclerosis, an autoimmune demyelinating disease, is the most common disorder of myelin, affecting young adults. It often pursues a relapsing-remitting course, with eventual progressive accumulation of neurologic deficits.

Question 16

What do other, less common forms of immune-mediated demyelination often lead to?

Answer 16

Infections, and are more acute illnesses (than MS)

Question 17

What are leukodystrophies?

Answer 17

Leukodystrophies are genetic disorders in which myelin production or turnover is abnormal.

Question 18

Neurodegenerative diseases cause symptoms that depend on the pattern of brain involvement. What do cortical diseases usually manifest as?

Answer 18

Cognitive change, alterations in personality, and memory disturbances

Question 19

Neurodegenerative diseases cause symptoms that depend on the pattern of brain involvement. What do basal ganglia disorders usually manifest as?

Answer 19

Movement disorders

Question 20

What is the pathological hallmark of many neurodegenerative diseases?

Answer 20

Protein aggregates

Question 21

How is the ‘theory’ of protein aggregation proven in familial forms?

Answer 21

The diseases are often associated with a mutation in the genes encoding these proteins or controlling their metabolism

Question 22

True/false: all neurodegenerative diseases progress slowly

Answer 22

False (Some of these protein aggregates can show prion like properties, facilitating spread from one cell to the next)

Question 23

Which dementia is most common?

Answer 23

Alzheimer’s Disease (AD)

Question 24

What proteins aggregate in AD / what are the hallmarks of AD?

Answer 24

plaques of Aß and tangles of tau

Question 25

What are other predominantly dementing diseases?

Answer 25

various forms of FTLDs (both forms with tau-containing lesions and with other types of inclusions) and dementia with Lewy bodies (with α-synuclein containing lesions).

Question 26

Which disease is the most common among the hypo kinetic movement disorders? And which protein aggregates?

Answer 26

Parkinsons Disease (PD) with α-synuclein containing inclusions

Question 27

Which is the most common form of motor neuron disease?

Answer 27

Amyotrophic lateral sclerosis (ALS)

Question 28

True/false: ALS can be either genetic or sporadic

Answer 28

True

Question 29

Tumors of the CNS may arise from the cells of the coverings (i), the brain (ii, ii, ii), or other CNS cell populations (iii, iii), or they may originate elsewhere in the body (iiii).

Answer 29

i: meningiomas
ii: gliomas, neuronal tumors, choroid plexus tumors
iii: primary CNS lymphoma, germ cell tumors
iiii: metastases

Question 30

True/false: Low-grade or benign tumors can have poor clinical outcomes

Answer 30

True, depending on where they occur in the brain

Question 31

Distinct types of tumors affect specific brain regions and specific age populations. What are examples of specific brain regions?

Answer 31

e.g. cerebellum for medulloblastoma, an intraventricular location for central neurocytoma

Question 32

Distinct types of tumors affect specific brain regions and specific age populations. What are examples of specific age populations?

Answer 32

medulloblastoma and pilocytic astrocytomas in pediatric age groups, and glioblastoma and lymphoma in older patients

Question 33

In which groups are glial tumors broadly classified?

Answer 33

astrocytomas, oligodendrogliomas, and ependymomas

Question 34

Increasing tumor malignancy is associated with ..

Answer 34

more cytologic anaplasia, increased cell density, necrosis, and mitotic activity

Question 35

True/false: Metastatic spread of brain tumors to other regions of the body is common

Answer 35

False, it is rare

Question 36

Which tumors are the dominant type that metastasize to the nervous system?

Answer 36

Carcinomas