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92 Cards in this Set
- Front
- Back
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Amygdala (bilateral)
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Klüver-Bucy syndrome (hyperorality, hypersexuality, disinhibited behavior)
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What are the characteristics of a frontal lobe lesion?
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Disinhibition and deficits in concentration, orientation and judgment
may have reemergence of primitive reflexes |
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Damage to the right parietal lobe can result in what?
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Spatial neglect syndrome (agnosia of the contralateral side of the world)
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Damage to the reticular activating system (midbrain) results in what?
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Wernicke-Korsakoff syndrome
Wernicke - confusion, opthalmoplegia, ataxia Korsakoff - memory loss, confabulation, personality changes |
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Lesions of the basal ganglia result in what?
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May result in tremor at rest, chorea, or athetosis.
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Lesions of the cerebellar hemisphere result in what?
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Intention tremor, limb ataxia
Ipsilateral deficits |
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What are the results of damage to the cerebellar vermis?
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truncal ataxia, dysarthria
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Subthalamic nucleus
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Contralateral hemiballismus
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Damage to the hippocampus can result in what?
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Anterograde amnesia - inability to make new memories
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What is the behavior of the eyes with paramedian pontine reticular formation (PPRF) lesions?
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Eyes look away from side of lesion
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Eye behavior in frontal eye field lesion?
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eyes look toward lesion
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Respiratory pattern associated with damage here?
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Deep forebrain
Cheyne-Stokes prespiratory pattern. |
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Breathing pattern?
Associated with damage to what area of CNS? |
Cheyne-Stokes.
Deep forebrain. |
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Damage associated with what breathing pattern?
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Midbrain
Central Neurogenic Hyperventilation. |
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Breathing pattern?
Associated with damage to what part of the CNS? |
Central Neurogenic Hyperventilation.
Midbrain. |
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Respiratory pattern associated with damage here?
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Rostral pons
Apneustic breathing. |
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Breathing pattern?
Associated with damage to what part of the CNS? |
Apneustic Breathing.
Rostral pons. |
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Breathing pattern associated with damage here?
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Midpons
Cluster breathing. |
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Breathing pattern?
Associated with damage to what part of the CNS? |
Cluster Breathing.
Midpons. |
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Breathing pattern associated with damage here?
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Caudal pons or rostral medulla
Ataxic breathing. |
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Breathing pattern?
Associated with damage to what part of the CNS? |
Ataxic breathing.
Caudal pons or rostral medulla. |
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Damage associated with what type of respiratory pattern?
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Respiratory centers in mid-medulla
Respiratory arrest. |
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Breathing pattern?
Associated with damage to what part of the CNS? |
Respiratory arrest.
Respiratory centers in mid-medulla. |
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List the adult peak incidence tumors
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-- Glioblastoma multiforme (grade IV astrocytoma)
-- Meningioma -- Schwannoma -- Oligodendroglioma -- Pituitary adenoma |
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Describe oligodendroglioma
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-- rare
-- slow growing -- frontal lobes -- chicken-wire capillary pattern -- "fried egg" cells (round nuclei with clear cytoplasm) -- calcified |
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Childhood peak incidence primary brain tumors
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-- Pilocytic (low-grade) astrocytoma
-- medulloblastoma -- ependymoma -- hemangioblastoma -- craniopharyngioma |
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Describe pilocytic (low-grade) astrocytoma
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-- well circumscribed
-- posterior fossa, may be supratentorial -- GFAP positive -- benign, good prognosis -- Rosenthal fibers (eosinophilic corkscrew fibers) -- cystic and solid |
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Common characteristics of craniopharyngiomas
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-- often cystic and multiloculated
-- benign childhood tumor -- confused with pituitary adenoma -- calcification common in adamantinomatous form with projections into adjacent brain tissue eliciting an intense inflammatory reaction -- filled with rich, cholesterol-containing cystic fluid -- papillary form lacks calcification, keratin and cysts |
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Primary brain tumors (rarely/often) metasize?
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rarely
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The majority of adult primary brain tumors are ___________ whereas the majority of childhood primary brain tumors are ____________.
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supratentorial/infratentorial
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Half of all adult brain tumors are of what origin?
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metastases from other cancers
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metastatic brain tumors usually have what characteristics?
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well circumscribed
usually present at the gray-white junction |
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What is the most common primary brain tumor?
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Glioblastoma multiforme
(grade IV astrocytoma) |
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What is the prognosis for Glioblastoma multiforme?
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Grave (< 1 year life expectancy)
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Where is glioblastoma multiforme usually found?
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in the cerebral hemispheres
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What primary brain tumor can cross the corpus callosum forming a butterfly glioma?
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Glioblastoma multiforme
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What primary brain tumor has astrocytes that stain positive for GFAP?
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Glioblastoma multiforme
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What primary brain tumor displays pseudopalisading, pleomorphic tumor cells that border central areas of necrosis and hemorrhage?
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Glioblastoma multiforme
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Glioblastoma multiforme is most often a tumor of (adults/children)?
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Glioblastoma multiforme is an adult peak incidence tumor.
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What group of tumors does medulloblastoma derive from?
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PNET (primitive neuroectodermal tumors)
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Where is medulloblastoma typically found
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Cerebellum, but highly malignant and disseminates throughout the CNS early in its course
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What structural syndrome can arise from medulloblastoma
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hydrocephalus from compression of the 4th ventricle
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Medulloblastoma histology
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Rosettes or perivascular pseudorosette cellular pattern, small blue cells
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Treatment of Medulloblastoma?
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Aggressive surgery, craniospinal radiotherapy and chemotherapy
50% of children free of disease in 5 years, 80-90% without mets can be cured. |
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Principle cause of Lacuar stroke
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HTN induces lipohyalinotic thickening of the small vessels
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Classic Lacunar stroke syndromes
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- dysarthria-clumsy hand syndrome
- pure motor hemiparesis - pure sensory stroke - ataxic-hemiparesis |
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Where is the stroke in dysarthric-clumsy hand syndrome?
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Lacunar stroke of the basal pons
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Where is the stroke in pure motor hemiparesis
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lacunar infarction on the posterior limb of the internal capsule
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Locate a pure sensory stroke.
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Lacunar stroke in the ventroposterolateral nucleus of the thalamus
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Where is the stroke in ataxic-hemiparesis
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Lacunar stroke at the anterior limb of the internal capsule
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Locate: Hand weakness, mild motor aphasia, no sensory abnormalities
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- Lacunar stroke in the basal pons
- dysarthria-clumsy hand syndrome |
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Describe dysarthia-clumsy hand syndrome
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- Lacunar stroke in the basal pons
- Hand weakness, mild motor aphasia, no sensory abnormalities |
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Locate: unilateral motor deficit (face, arm, leg), mild dysarthia, no sensory, visual or higher cortical dysfunction
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- Pure motor hemiparesis
- lacunar infarction in Posterior limb of the internal capsule |
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Describe pure motor hemiparesis
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- lacunar infarction in Posterior limb of the internal capsule
- unilateral motor deficit (face, arm, leg), mild dysarthia, no sensory, visual or higher cortical dysfunction |
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Locate: unilateral numbness, paresthesias and hemisensory deficit involving face, arm, trunk and leg
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- pure sensory stroke
- lacunar stroke in the ventroposterolateral nucleus of the thalamus |
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Describe pure sensory stroke
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- lacunar stroke in the ventroposterolateral nucleus of the thalamus
- unilateral numbness, paresthesias and hemisensory deficit involving face, arm, trunk and leg |
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Locate: weakness that is more prominent in the lower extremity, ipsilateral arm and leg incoordination
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- ataxic-hemiparesis
- lacunar stroke at the anterior limb of the internal capsule |
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Describe ataxic-hemiparesis
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- lacunar stroke at the anterior limb of the internal capsule
- weakness that is more prominent in the lower extremity, ipsilateral arm and leg incoordination |
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Oligodendroglioma histology
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- chicken-wire capillary pattern
- fried egg cells (round nuclei with clear cytoplasm |
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Where are Oligodendroglioma's found?
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frontal lobes
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Most common type of pitituary adenoma?
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Prolactinoma
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Pituitary adenomas derive from what embryonic structure?
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Rathke's pouch
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General signs/symptoms of pituitary adenoma?
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- Bitemporal hemianopisa
- hyper- or hypopituitarism |
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What is the most common childhood supratentorial tumor?
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Craniopharyngioma
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What are Craniopharyngiomas derived from?
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vestigial remnants of Rathke's pouch
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2nd most common primary brain tumor?
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Meningioma
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Where are Meningiomas found?
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convexities of hemispheres and parasagittal region
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From what cells do Meningiomas arise?
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Arachnoid cells external to the brain.
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Treatment of meningiomas?
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resectable
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Meningioma histology
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spindle cells concentrically arranged in a whorled pattern
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psammoma bodies (laminated calcification)
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Meningioma
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Ependymal cell tumors?
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Ependymoma
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Where are ependymomas most often found? Leading to what problem?
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4th ventricle most common, leading to hydrocephalus
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Prognosis for ependymomas?
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poor
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Histology of ependymoma
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-- characteristic perivascular pseudorosettes
-- rod-shaped blepharoplasts (basal ciliary bodies) near nucleus |
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3rd most common primary brain tumor?
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Schwannoma
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Name of a schwannoma that is localized to CN VIII
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acoustic schwannoma, found at the cerebellopontine angle
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How are schwannomas generally dealt with?
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rescetable
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Schwannoma tumor marker?
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S-100 positive
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Bilateral schwannomas?
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NF2
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Where are hemangioblastomas found?
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Cerebellum
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Hemangioblastoma and retinal angiomas
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von Hippel Lindau syndrome
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What hormone does hemangioblastoma produce and related problem?
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EPO → polycythemia
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Hemangioblastoma histology
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-- foamy cells
-- high vascularity |
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Lacunar infarct
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- posterior limb of the internal capsule
- motor impairment without any higher cortical dysfunction or visual field abnormalities |
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Brain lesion that yields:
motor impairment without any higher cortical dysfunction or visual field abnormalities |
Posterior limb of the internal capsule - most often lacunar - infarct.
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Middle cerebral artery occlusion
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- contralateral hemiplegia
- conjugate eye deviation towards the side of infarct - hemianesthesia - homonymous hemianopia - aphasia (dominant hemisphere) - hemineglect (non-dominant hemisphere) |
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Brain lesion that yields:
- contralateral hemiplegia - conjugate eye deviation towards the side of infarct - hemianesthesia - homonymous hemianopia - aphasia (dominant hemisphere) - hemineglect (non-dominant hemisphere) |
Middle cerebral artery occlusion
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Anterior cerebral artery occlusion
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- contralateral weakness that predominantly affects the lower extremity
- abulia - akinetic mutism - emotional disturbances - deviation of head and eyes toward the lesion - sphincter incontinence |
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Brain lesion that yields:
- contralateral weakness that predominantly affects the lower extremity - abulia - akinetic mutism - emotional disturbances - deviation of head and eyes toward the lesion - sphincter incontinence |
Anterior cerebral artery occlusion
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Vertebrobasilar system lesion
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- alternate syndromes
- contralateral hemiplegia - ipsilateral cranial nerve involvement |
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Brain lesion that yields:
- alternate syndromes - contralateral hemiplegia - ipsilateral cranial nerve involvement |
Vertebrobasilar system lesion
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