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112 Cards in this Set
- Front
- Back
- 3rd side (hint)
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How many milliliters of CSF are produced per day?
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500 ml
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How much CSF is within the ventricles?
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25 ml
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Name two degenerative diseases that primarily involve the basal ganglia and mesencephalon?
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Parkinson's Disease
Huntington Disease |
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Where is the obstruction located in noncommunicating hydrocephalus?
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Within the ventricular system
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Where is the obstruction located in communicating hydrocephalus?
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Within the subarachnoid space or arachnoid villi
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What is the gross pathology of Parkinson's disease?
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Depigmentation of substantia nigra
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What is the histopathology of Parkinson's disease? (4)
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1. Degeneration of neurons in substantia nigra and locus ceruleus
2. Lewy bodies (idiopathic PD) 3. Neurofibrillary tangles (postencephalitic PD) 4. Degeneration of dopaminergic striatonigral pathway |
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What is the usual cause of cellular brain edema?
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Ischemia
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Where is vasogenic brain edema located? (gray or white matter)
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White matter
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Where is cellular (cytotoxic) brain edema located? (gray or white matter)
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Both, but gray is more significant
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Periventricular edema is indicative of what condition?
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Hydrocephalus
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What is the gross pathology of Huntington Disease?
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Atrophy of caudate nucleus and putamen
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What is the histopathology of Huntington disease? (4)
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1. Loss of major projection neurons in striatum
2. Intranuclear inclusions in neurons 3. Loss of neurons in globus pallidus 4. Mild to moderate cerebral cortical atrophy |
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What is the histopathology of ALS? (5)
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1. Loss of large motor neurons with gliosis
2. Degeneration of cortico-spinal (pyramidal) tracts 3. Bunina bodies and other ubiquitin positive cytoplasmic inclusions in some motor neurons 4. Degeneration of anterior spinal roots 5. Neurogenic atrophy of skeletal muscles |
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What is the gross pathology of Alzheimer's disease?
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Diffuse cerebral cortical atrophy
Hydrocephalus ex vacuo |
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What is the gross pathology of dementia with Lewy bodies? (3)
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1. Some degree of diffuse cerebral atrophy is likely to be present
2. Variable pallor of the substantia nigra is likely to be present 3. Locus ceruleus is usually depigmented |
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What is the cause of hydrocephalus in TB meningitis?
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Meningial fibrosis
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What type of meningitis has characteristic dilatation of the Virchow-Robin (perivascular) spaces in the basal ganglia?
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Cryptococcal leptomeningitis
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What is the histopathology of dementia with Lewy bodies?
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1. Lewy bodies of both classical and cortical types
2. Alzheimer-type pathology (senile plaques & neurofibrillary tangles) |
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What type of pathogen is the most common cause of encephalitis?
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Viruses
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What is the pathology of viral encephalitis? (4)
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1. Necrosis with hemorrhage
2. Perivascular chronic inflammation 3. Microglial nodules 4. Sometimes viral inclusions |
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Where does herpes encephalitis typically localize?
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Temporal and frontal lobes
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Where does the polio virus localize in the CNS?
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Anterior horn cells
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What is the most common cause of coma in the absence of an intracranial hematoma?
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Diffuse axonal injury
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What immunohistochemical stain can serve as a sensitive marker to diffuse axonal injury?
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APP
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What type of hematoma is found in shaken baby syndrome?
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Subdural
(often bilateral) |
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What is typically the source of bleeding in a subdural hematoma?
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Bridging veins
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What is typically the source of bleeding in an epidural hematoma?
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Meningeal artery (usually middle)
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What are the typical shapes of subdural and epidural hematomas?
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Epidural = convex or lens
Subdural = crescent |
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In which lobes do brain contusions most commonly occur?
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Temporal and frontal
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Where are focal hemorrhages found in the gross pathology of diffuse axonal injury?
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Parasagittal white matter
Corpus callosum Dorsolateral quadrants of rostral brainstem |
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Where do pilocytic astrocytomas commonly occur?
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Cerebellum
Hypothalamus Optic nerve |
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What age group are pilocytic astrocytomas most common in?
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Young (1-3 decades)
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What is the histological pattern of pilocytic astrocytoma? (3)
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Biphasic growth pattern
Solid & microcystic Degenerative astrocytic changes |
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What is the radiological finding of diffuse astrocytoma?
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T2 hyperintensity on non-contrast MRI
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What is the histological pattern of diffuse astrocytoma?
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Diffuse infiltration by cytologically atypical cells
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What is the histological feature that distinguishes anaplastic astrocytoma from diffuse astrocytoma?
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Mitotic activity
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What is the radiological finding typical of a glioblastoma?
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(Ring) enhancement on post-contrast T1 weighted MRI
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What are histological findings that distinguish glioblastoma from other gliomas?
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Microvascual proliferation (with leaky blook vessels)
Necrosis (pseupalisading) |
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What type of brain tumor is frequently calcified?
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Oligodendroglioma
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What are the genetic features that are typical of oligodendrogliomas and how does their presence affect the tumor's prognosis?
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LOH 1p and 19q
Presence of both is favorable and indicates likely response to chemotherapy |
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What are the six most common locations for meningiomas?
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Parasagittal/flacine
Convexity Sphenoid wing Suprasellar Olfactory groove Posterior fossa |
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What is the frequency of metastatic brain tumors as compared to primary tumors?
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10x more frequent
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What are the most common sites for ependymomas?
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Cerebellum and Spinal Cord
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What grade is the majority of ependymomas?
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Grade II
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What is the most common familial cancer syndrome and what are the associated cancers of the syndrome?
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NF1
Neurofibromas and optic nerve gliomas (pilocytic) |
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Meningiomas and Scwannomas are associated with which familial cancer syndrome?
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NF2
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What are the two types of peripheral nerve tumors?
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Neurofibroma
Schwannoma |
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Iris hamartomas are typically found in what type of CNS tumor syndrome?
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NF1
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A biphasic neoplasm and verocay bodies are found in the histology of what cancer?
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Schwannoma
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What is the most common type of embryonal brain tumor?
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Medulloblastoma
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What two things can cause the symptoms associated with pituitary adenoma?
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Hormone production
Mass effects |
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What are the four most frequent primary sites of intraparenchymal metastatic tumors?
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Lung
Breast Skin Kidney |
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What is the most common primary brain tumor?
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Meningioma
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What percentage of strokes are ischemic?
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80%
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Which is more vulnerable to ischemia: neurons or glial cells; white matter or gray matter?
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Neurons, Gray matter
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Neurons of which four parts of the brain are most vulnerable to ischemia?
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1. Cerebral cortex
2. Hippocampus 3. Deep cerebral nuclei 4. Purkinje cells of cerebellum |
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What will eventually form in an area of pan-necrosis?
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A cavity
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In ischemic strokes, what is focal ischemia due to?
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Occlusion of a blood vessel
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In ischemic strokes, what is global ishemia due to? (3)
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1. Cardiac arrest
2. Systemic hypotension 3. Increased intracranial pressure |
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During what time period following a stroke is the mass effect primarily present?
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The first week
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Where do lacunar infarcts occur? (3)
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1. Cerebral white matter and internal capsule
2. Deep cerebral gray mater (basal ganglia, thalamus) 3. Pons |
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What is the most common cause of intracerebral hemorrhage?
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Hypertension
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What are three brain related diseases associated with small-vessel arteriosclerosis?
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1. Intracerebral hemorrhage
2. Lacunar infarct 3. Binswanger's disease |
None
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What is the most common cause of subarachnoid hemorhage?
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Ruptured berry aneurysms
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85% of berry aneurysms are found in what part of the cerebral circulation?
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Anterior (ICA) circulation
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What is the most common location for berry aneurysms (40%)?
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Junction of the anterior cerebral artery and the anterior communicating artery
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What portion of patients that suffer from aneurysmal subarachnoid hemorrhage die from the event?
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33%
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What is seen microscopically on the first day of a stroke?
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1. Coagulative necrosis of neurons (red neurons)
2. Tissue edema 3. Influx of neutrophils |
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What is seen microscopically on the second day of a stroke?
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Macrophages and maximal edema
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What is seen microscopically on the third day of a stroke?
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Proliferation of astrocytes
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Which is the more common type of hemorrhagic storke?
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Intraparenchymal hemorrhage
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What are four consequences of an intercerebral hemorrhage?
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1. Local brain destruction
2. Mass effect 3. Extension into ventricles (hydrocephelus) 4. Seizures |
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What is the leading cause of morbidity and mortality in aneurysmal subarachnoid hemorrhage?
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Arterial vasospasm
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What is the predominant clinical symptom of degenerative diseases primarily involving the cerebral cortex?
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Dementia
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Are metabolic and nutritional diseases among the major causes of dementia?
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Yes
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What is a common cause of intracerebral hemorrhage in elderly individuals and Alzheimer disease patients?
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Amyloid angiopathy
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What are the neurofibrillary tangles of Alzheimer's disease composed of?
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Intraneuronal tau protein aggregates
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What is seen in this image?
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β-amyloid deposit of Alzheimer's disease
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What is seen in this image
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Senile plaque
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What is seen in this image?
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Neurofibrillary tangles
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What is seen in this image?
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Cortical Lewy bodies
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What is the pathology of prion disease? (5)
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1. Cerebral and/or cerebellar atrophy in some cases
2. PrP amyoid plaque (deposit) 3. Spongy vacuolation of neuropil 4. Neuronal loss 5. Glial hypertrophy and proliferation (gliosis) |
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What disease process is seen in this image?
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Prion disease
(spongy changes) |
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What disease is see in these images?
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Variant CJD
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What is the predominant clinical symptom of degenerative diseases primarily involving the basal ganglia and mesencephalon?
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Movement disorders
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What is the predominant clinical symptom of degenerative diseases primarily involving the basal ganglia and mesencephalon?
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Movement disorders
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What is the disease process seen in this image?
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Lewy bodies in Parkinson's disease
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What disease process is seen in the spinal cord of the patient on the right?
(left image is normal) |
ALS
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What is seen in this image?
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Epidural hematoma
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What traumatic brain injury is seen in this image?
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Subdural hematoma
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What is an early clinical sign of uncal herniation?
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Ipsilateral pupil dilation
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What are early clinical signs of central diencephalic herniation (transtentorial) herniation?
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Drowsiness and small pupils
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What are the four primary symptoms of hydrocephalus?
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Headache
Nausea Vomiting Papilledema |
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What are five common causes of hydrocephalus?
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1. Aqueductal stenosis
2. Chiari II malformation 3. Dandy-Walker malformation 4. Post-inflammatory hydrocephalus or post-hemorrhagic hydrocephalus 5. Tumors |
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This image of the basal ganglia is characteristic of what infectious disease of the brain?
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Cryptococcal leptomeningitis
(characteristic dilatation of the Virchow-Robin (perivascular) spaces in the basal ganglia) |
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What areas of the brain does HSV-1 infection preferentially involve?
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Temporal lobes
Inferior frontal lobes |
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What parts of the nervous system does poliovirus preferentially infect?
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Motor neurons of spinal cord
Brain stem |
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What cell type does JC virus preferentially infect?
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Oligodendrocytes
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What areas of the brain does rabies virus typically infect?
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Hippocampus
Cerebellum |
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What part of the nervous system does varicella-zoster virus typically infect?
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Dorsal root ganglia
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The temporal lobe localization and hemorrhagic necrosis seen in this image is typical of what type of encephalitis?
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Herpes encephalitis
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What consequence of the mass effect is seen in this image?
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Uncal herniation
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The biphasic growth pattern seen in this image is typical of what brain tumor?
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Pilocytic astrocytoma
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What glioma is seen in this image?
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Anaplastic astrocytoma
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Which type of glioma is seen in this image?
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Glioblastoma
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What type of glioma is seen in this image?
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Oligodendroglioma
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What type of brain tumor is seen in this image?
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Ependymoma
(rosettes) |
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What type of tumor is seen in this image?
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Parafalcine meningioma
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What type of brain tumor is seen in these images?
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Schwannoma
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The image above would be expected on what day of a stroke?
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The first
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This image would be expected on what day following a stroke?
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Third
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