Neuro-Path-Cerebral Edema: Bbb

Front 1

what causes cerebral edema AKA brain swelling

Back 1

abnl influx of fluid from intravascular compartment into interstitial or extracellular space of CNS parenchyuma, esp white matter

Front 2

what happens to gyri in cerebral edema

Back 2

they swell and flatten

Front 3

midline shift

Back 3

unilateral injury causes swelling, which displaces the interhemispheric midline toward the other side

Front 4

cerebral edema implies

Back 4

vasogenic edema

Front 5

what is MC form of brain swelling

Back 5

vasogenic edema

Front 6

vasogenic edema

Back 6

reflects damage to endothelial cells of vasculature-->compormises the "tight" (adherent) endothelial junctions-->lose barrier fxn

Front 7

BBB

Back 7

barrier fxn provided by unmique tight endothelial (near vessel) jxns of CNS

Front 8

cytotoxic edema

Back 8

*brain swelling d/t incr INTRACELLULAR accum of fluid, esp with neurons, d/t toxic-metabolic dz
*gray matter

Front 9

hydrocephalic edema

Back 9

obstructive hydrocephalus==>
stretching of ependymal cells lining the dilated ventricle
==>ependymal cell margins are opened
==>CSF enters adjacent CNS parenchyma

Front 10

critical mass for resultant herniation of brain

Back 10

1300 grams

Front 11

subfalcine hemorrhage

Back 11

-lateral displacement of cingulate gyrus of injured/swollen hemisphere thru the subfalcine space, beneath the free margin of the falx
*ACA

Front 12

transtentortial herniation

Back 12

-hippocampal gyrus (medial gyrus of inferior surface of temporary lobe) herniates thru tentorial notch
-mild forms: only uncus herniates thru tentortial notch
*PCA
*blown (fixed, dilated) pupil on ipsilateral side d/t compression of oculomotor nerve (PSNS)-->SNS predominates

Front 13

hippocampal gyrus

Back 13

medial gyrus of inferior surface of temporal lobe

Front 14

blown pupil

Back 14

fixed dlated pupil on ipsilaterla side d/t compression of oculomotor nerve (PSNS)
-->SNS predominates
*reliable localizing sign, indicating injury is on ipsilateral hemisphere (better localizing sign than hemiparesis)

Front 15

Kernohan's Notch Phenomenon

Back 15

false localizing sign, resulting from severe Transtentorial Herniation of injured cerebral hemisphere

i.e. hit right side
-->compress left corticosp tract-->hemiparesis on right side (ipsi hemiparesis)

hemiparesis is usually contralateral, but here it's ipsi (thus false localizing sign)

Front 16

tonsillar herniation

Back 16

both cerebellar tonsils forced thru foramen magnum
-->can compress adjacent cardio-resp centers in medulla
-->death

Front 17

central (axial) herniation

Back 17

entire brain stem forced downward along its own axis
-->basilar artery branches ripped out of parenchyma
-->massive focal hemorrhages in brainstein, esp at midbrain and upper pons ("Duret hemorrhage")

Front 18

Duret hemorrhage

Back 18

massive focal hemorrhages in brainstein, esp at midbrain and upper pons d/t ripping out branches of basilar artery during central (axial) herniation

Front 19

fungus cerebrei

Back 19

-extrustion of brain thru abnl aperture in skull d/t trauma
-swollen cortex and parenchyma extrudes thru the defect, resembling a mushroom with a narrow base at the aperture and ballooned dome of necrotic parenchyma

Front 20

hydrocephalus

Back 20

abnormally dilated ventricles (filled iwth CSF)

Front 21

non-communicating hydrocephalus

Back 21

-AKA obstructive hydrocephalus
-dilation of entire ventricular system above a point of blockage or stricture
-often situated at natural bottle neck, such as aquaduct or 4th ventricle

Front 22

communicating hydrocephalus

Back 22

-AKA non-obstructive hydrocephalus
-generalized blcokage of nl CSF circulation
-eg occlude posterior fossa outlet foraminae of Luschka and Magendie

Front 23

ex vacuo hydrocephalus

Back 23

-dilation of entire ventricular system related to adjacent injury and subsequent atrophy or resorption of damaged CNS parenchyma
-eg Alz Dz