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135 Cards in this Set
- Front
- Back
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Star-shaped appearance
GFAP Metabolic buffers/detoxifiers/barriers Injured: Gliosis |
Astrocytes
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Long-term HYPERAMMONEMIA
d/t Liver Disease, Wilson Disease, Urea Cycle Disorders |
Alzheimer Type II Astrocyte
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"Rosenthal Fibers" in Tumor
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Pilocytic Astrocytoma
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"Lafora Bodies" in cytoplasm of neurons
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Myoclonic Epilepsy
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Edema caused by BBB disruption
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Vasogenic Edema
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Accumulation of excessive CSF w/in the ventricular system
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Hydrocephalus
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Displacement of Cingulate Gyrus under the Falx Cerebri
Leads to compression of ACA |
Subfalcine Herniation
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Medial temporal lobe compressed against tentorium
CN III problems (dilation and loss of EOM) Extreme: change in peduncle called "Kernohan's Notch" |
Transtentorial Herniation
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Cerebellar tonsils through the Foramen Magnum
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Tonsillar Herniation
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Diverticulum of CNS through defect in cranium
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Encephalocele
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Extension of CNS tissue through defect in VC
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Myelomeningocele
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Extension of only meningeal tissue thru defect in VC
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Meningocele
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Major cause of NTD's
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Folate Deficiency
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Malformation of the Anterior End of the NT
ABSENT BRAIN AND CALVARIUM |
Anencephaly
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Smoothed surface brain
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Lissencephaly
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Migrational disorders associated w/ Epilepsy
Collections of neurons in inappropriate locations along migrational pathway Periventricular type caused by mutation in Filamin A |
Neuronal Heterotopias
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Cyclopia and Midline facial defects
Trisomy 13 Sonic Hedgehog |
Holoprosencephaly
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Bat-wing Deformity
No WM Bundles to carry information between Hemispheres |
Agenesis of the Corpus Callosum
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Enlarged Posterior Fossa
Absent Cerebellar Vermis |
Dandy-Walker Malformation
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Downward extension of Vermis through FM
Small Posterior Fossa Misshapen midline Cerebellum Hydrocephalus and Lumbar Myelomeningocele |
Arnold-Chiari Malformation Type II
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Extension of Cerebellar Tonsils through VC
Small Posterior Fossa Misshapen midline Cerebellum Hydrocephalus and Lumbar Myelomeningocele |
Arnold-Chiari Malformation Type I
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UE loss of PAIN AND TEMPERATURE
Fluid-filled Cleft Cavity of Inner Portion of the Cord Associated w/ Chiari Type I |
Syringomyelia
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Perinatal/Prenatal Injury
Non-Progressive NMD Combo of Symptoms |
Cerebral Palsy
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Marble-like appearance of the deep nuclei
D/t abberant and irregular myelinization |
Status Marmoratus
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Fall while Awake
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Occipital Injury
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Fall after Syncope or LoC
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Frontal Injury
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Bruising of the brain, especially the crests of Gyri
Wedge Shaped Lesion Can become site of ectopic foci |
Contusion
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Contusion at the Point of Impact
Usually when Head is Immobile |
Coup
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Contusion at surface OPPOSITE the Point of Impact
Occurs when Head is Mobile |
Contrecoup
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Lucid Interval
Rupture of MMA @ Pterion Dura seperate from Skull |
Epidural Hematoma
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Rupture of Bridging Veins
Manifest w/in 24-48 hours Headache and confusion "Shaken Babies" |
Subdural Hematoma
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Generalized reduction of cerebral perfusion
Causes: cardiac arrest, shock, severe hypotension |
Global Cerebral Ischemia
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Reduction in blood supply to localized area of the brain
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Focal Cerebral Ischemia
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Type of Necrosis seen in the brain
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LIQUIFACTIVE NECROSIS
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Most vulnerable cell types to ischemia:
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1. Neurons
2. Astrocytes 3. Oligodendrocytes |
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SICKLE SHAPED band of NECROSIS over Cerebral Convexity
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ACA-MCA Watershed Infarct
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Red Neurons (12-24 hours)
Microvacuolization and Eosinophilia Pyknosis and Karyorrhexis |
EARLY CHANGES of IRREVERSIBLE ISCHEMIC INJURY
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24 hours to 2 weeks
Necrosis of Tissue Influx of Macros Reactive Gliosi |
SUBACUTE CHANGES of IRREVERSIBLE ISCHEMIC INJURY
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Removal of Necrotic Tissue (after 2 weeks)
Loss of normal CNS organizational structure |
REPAIR PHASE of IRREVERSIBLE ISCHEMIC INJURY
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Mulitple, confluent, petechial hemorrages
Associated w/ EMBOLIC events |
Hemorrhagic Infarct
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Pale, bland, anemic infarcts
Associated w/ THROMBOTIC events Time Frame and Macroscopic Appearance? 48 hours? 2-10 days? 10-30 days? |
Non-hemorrhagic Infarct
48 hours: Pale, 2-10 days: gelatinous and friable, 10-30 days: liquifies and fluid filled cavity |
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Reactive Astrocytes seen when?
Infarcts happen from edges inward or outward? |
1 week after the incidient
Inward |
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Reabsorbed hemorrhage that leaves slitlike cavity surrounded by brown discoloration
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Slit Hemorrhages
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d/t Malignant HTN
HA, confusion, V and convulsions - can lead to coma Edematous brain w/o herniation |
Hypertensive Encephalopathy
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Dementia, Gait abnormalities, and pseudobulbar signs
* multiple, repeated, white and Gray matter infarcts |
Vascular (multi-infarct) Dementia
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Dementia, Gait abnormalities, and pseudobulbar signs
* involves large areas of subcortical WHITE matter w/ myelin and axonal loss |
Binswanger Disease
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HTN and CAA
Over 60 y/o Small vessel |
Intracerebral (Intraparenchymal) Hemorrhage
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Minute aneurysms d/t chronic HTN
Most common in BG |
Charcot-Bouchard microaneurysms
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Amyloid peptide deposition in vessel walls
Involved vessels appear "stiff" Results in weakening of wall and rupture |
CAA
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Alleles associated with increased risk of repeat bleeds
ApoE polymorphism |
E2 or E4
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Rare hereditary form of stroke d/t mutated Notch3 R
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CADASIL
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Most common site for Saccular (Berry) Aneurysm
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Anterior Circulation (ACA/Ant. Comm.)
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Network of wormlike vascular channels
Pulsatile AV shunting of high blood flow Subarachnoid vessels extending into brain parenchyma |
Arteriovenous Malformation
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Venous malformation of the SC/meninges
Ischemic myelomalacia and slow neurologic symptoms |
Foix-Alajouanine Disease
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Microscopic foci of dilated, thin walled vascular channels
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Capillary telangiectasias
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Cause of Bacterial Meningitis in Neonates
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GBS
E. coli |
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Cause of Bacterial Meningitis in Elderly
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S. pneumo
Listeria |
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Most common cause of Bacterial Meningitis in Adults?
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Neisseria
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Protein: Increased
Glucose: Decreased Cloudy/Purulent CSF |
Bacterial Meningitis
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Cause of Bacterial Meningitis in the Immunosuppressed
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Klebsiella
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Protein: Increased
Glucose: Normal Lymphocytes: Increased |
Aseptic (Viral) Meningitis
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Discrete lesion w/ central liquefactive necrosis
Associated with Sinusitis WBC/Protein/CSF pressure increased Glucose is normal |
Brain Abscess
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Bacterial or fungal infection that spread to the subdural space
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Subdural empyema
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White granules spread over leptomeninges
Arteries in SUBA space show OBLITERATIVE ENDARTERITIS Acid Fast Stain |
Tuberculosis
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Absence of DTR
Lightning pains Ataxia Charcot Joints Spirochete damage to sensory nerves in DR |
Tabes Dorsalis
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Aseptic Meningitis
Facial Nerve Palsy Encephalopathy |
Lyme Disease
Neuroborreliosis |
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Polio-like syndrome with Paralysis
CSF colorless, but slightly elevated pressure |
West Nile Virus
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Cowdry Type A in neurons and glia
Altered mood, memory and behavior Kids and Young Adults |
HSV 1
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Passed vertically through birth canal
Acute hemorrhagic, necrotizing encephalitis |
HSV 2
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OWLS EYE inclusions in paraventricular regions
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CMV
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Fecal/Oral Transmission
Anterior Horn Motor Neuron Inflammation Aseptic meningitis - Flaccid Paralysis |
Polio
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Negri bodies
Pyramidal Neurons of hippocampus and purkinje cels |
Rabies
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JC virus
Progressive Neurologic Symptoms Infection of the Oligodendrocytes w/ JC Virus causes loss of myelin Multifocal lesions in the cerebrum/cerebellum |
PML
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MEASLES ASSOCIATION
Cognitive decline, spasticity of limbs, and seizures |
Subacute Sclerosing Panencephalitis
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Opportunistic Fungal Infection in AIDS
India Ink Stain "Soap Bubble" lesions |
Cryptococcal Meningitis
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Multiple ring enhancing lesions
HIV associated evolves in 1-2 weeks |
Toxoplasma gondii
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PrPSC, most common prion disease
Peaks in 7th decade Subtle then Rapid dementia course Involuntary jerky contractions |
CJD
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KURU PLAQUES = Extensive CORTICAL PLAQUES w/ HALO of Spongiform Change
No change in PRNP gene Slow progression in Young Adults |
vCJD
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Ataxia, ANS changes, stupor then coma
No spongiform change |
Fatal Familial Insomnia
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DEMYELINATION via TH1 and TH17 Autoimmunity
Oligoclonal Bands of Ig in the CSF Active (current myelin breakdown) and Inactive Plaques u/l vision impairment, CN issues |
MS
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b/l optic neuritis and spinal cord demyelination
Antibodies to Aquaporins (which maintain BBB) |
Neuromyelitis Optica
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diffuse demyelinating disease that follows immunization
grayish discoloration of white-matter vessels develops over a week or two headache, lethargy, and coma |
Acute disseminated encephalomyelitis (ADEM)
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follows an URI
fatal in most patients same as ADEM but more severe lesions hyperacute variant of ADEM |
Acute necrotizing hemorrhagic encephalomyelitis (ANHE)
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Rapid correction of hyponatremia
Rapid Quadriplegia Myelin loss w/o inflammation |
Central Pontine Myelinolysis
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Cortical Atrophy
Neuritic Plaques and Neurofibrillary Tangles Hirano Bodies Deposition of AB peptides Slow/relentless coarse - memory loss to pneumonia Trisomy 21 and Tau association Most common dementia in the elderly |
Alzheimers Disease
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Frontal and Temporal Atrophy
Tangles contain 4R or combo of 3R/4R Tau Mutations in MAPT |
FTD
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Progressive Dementia, Early Behavioral Change
Asymmetric atrophy Wafer thin (knife-edge) Gyri Pick Bodies |
Picks Disease
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Truncal Rigidity w/ Dysequilibrium
Nuchal Dystonia Pseudobulbar palsy Abnormal Speech Ocular Distrubances Mild Dementia Males, and Mostly Seventh Decade |
Progressive Supranuclear Palsy
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Disease of elderly - cortical atrophy
Rigidity, asymmetric motor dsyfx Tau immunoreactivity "Tufted Astrocytes" "Coiled Bodies" - oligodendrocytes LOSS OF PIGMENTED NEURONS IN SN AND LC |
Corticobasal Degeneration
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Pill-rolling Tremor
Short Gait Pallor of SN and LC A-Synuclein Lewy Body Reduction of Dopamine content |
Parkinson Disease
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Dementia w/ PD
Hallucinations and prominent frontal signs Lewy neurites |
Dementia w/ Lewy Bodies
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A-synuclein inclusions in glial cells
(i.e. Oligodendrocytes) Symptoms can be Parkinsonism, Cerebellar or ANS |
Multiple System Atrophy
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AD - progressive movement and dementia disorder
Chorea Dyskinesia and Rigidity CAG repeats Atrophy of the Caudate Nucleus |
Huntington Disease
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AR - starts in first decade of life
GAA repeats - Frataxin Heart is enlarged Gait ataxia, hand clumsiness, dysarthria DTR depressed or absent Extensor Plantar reflex is present Vibrational/Pain/Temp usually damaged |
Friedreich Ataxia
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AR - early childhood - ataxic/dyskinetic syndrome
Telangiectasias in the conjunctiva and skin Increased risk of BREAST CANCER |
Ataxia-Telangiectasia
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Loss of LMN in SC and UMN that project to CSTs
SOD1 - loss of ability to detoxify FR Reduced AHMN in the SC Bunina Bodies Fasiculations SC shows loss of Myelinated Fibers |
ALS
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Fasciculations of the Tongue and Dysphagia
Androgen insufficiency GYNECOMASTIA, Testicular Atrophy CAG repeat in Androgen Receptor |
Kennedy Syndrome
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Accumulation of Lipofuscin
Blindness, Mental/Motor Deterioration and seizures |
Neuronal Ceroid Lipofuscinoses
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Deficiency of Galactocerebroside B-galactosidase
Rapidly Progressive - White Matter is Yellow Onset at Age 3-6 Months Globoid Cells |
Krabbe Disease
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Deficiency of Lysosomal Enzyme Arylsulfatase A
Accumulate Cerebroside Sulfate |
Metachromatic Leukodystrophy
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Progressive - Atrophy of the Adrenal Cortex
Can't metabolize VLCFAs in serum X-linked Mutations in ALD gene |
Adrenoleukodystrophy
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Pendular eye movements
"Tigroid" appearance to tissue sections stained for myelin |
Pelizaeus-Merzbacher Disease
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Blind
Megalocephaly WM injury Accumulation of N-Actylaspartic Acid |
Canavan Disease
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Seizures and Psychomotor retardation
Rosenthal Fibers around BVs GFAP |
Alexander Disease
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Ataxia and Seizures
Levels of eIF2B are reduced throughout the body |
Vanishing White Matter Leukodystrophy
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Weakness, Lactic Acidosis, Stroke-like episodes
tRNAs |
MELAS
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myoclonus, seizures, ataxia, myopathy
tRNA different from MELAS Ragged Red Fibers |
MERRF
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EArly childhood, feeding problems, EO palsies
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Leigh Syndrome
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Mito DNA deletion - Neurons lost in Cerebellum
Spongiform change in W and G Matter |
Kearn-Sayre Syndrome
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Neuro + Hepatic
Seizures, Ataxia, and Blindness |
Alpers Disease
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Megaloblastic Anemia w/ Neuropathy
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B12 Deficiency
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Irreversible B1 deficiency w/ confabulation
Hemosiderin Laden Macros |
Korsakoff Syndrome
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Selective injury to Layers III/V of Cerebral Cortex
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CO
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Pseudopalisading Histologic Pattern
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Glioblastoma Multiforme
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Grade I Astrocytoma
Floor and Walls of the 4th Ventricle GFAP + |
Pilocytic Astrocytoma
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Lipized Astrocytes
Temporal Lobe Kids and Young Adults |
Pilocytic Xanthoastrocytoma
Grade II/IV |
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Cervicomedullary Junction
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Brainstem Glioma
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White matter
Well-circumscribed, better prognosis |
Oligodendroglioma
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Floor of the 4th Ventricle
NF2 association Perivascular Pseudorosettes Ependyma-lined ventricular system Manifest w/ Hydrocephalus |
Ependymomas
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Occur at Filum Terminale
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Myxopapillary Ependymomas
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Calcified, solid, slow growing nodule
Attached to Ventricular Lining |
Subependymomas
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Choroid Plexus Growth in Kids
Lateral Ventricle Growth in Adults |
Choroid Plexus Papillomas
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Cyst attached to roof of third ventricle
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Colloid Cyst of the 3rd Ventricle
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Midline of the cerebellum
Drop metastases – Cauda Equina Mostly Children- Highly malignant Poorly differentiated but Well-circumscribed Desmoplastic variant |
Medulloblastoma
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Presence of Rhabdoid Cells
Desmin and Myoglobin are not present as markers Highly malignant tumor of Young Children |
Rhabdoid Tumor
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Midline tumors
Pineal Gland or Suprasellar Region AFP and HCG increased in CSF |
Germ Cell Tumors
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Attached to the dura
Usually benign - loss of chromosome 22 En plaque Grwoth - sheet like fashion along the Dura Psammoma bodies |
Meningiomas
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¼ to ½ of intra-cranial tumors in hospitalized patients
Five most common: Lung Breast Melanoma Kidney GI |
Metastatic Tumors
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Which type of tumor does not follow the "sharply demarcated metastases rule"?
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Melanoma
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Neural crest-derived Schwann cell
NF2 Merlin loss Cerebellopontine Angle Acoustic neuroma – CN VIII (tinnitus and hearing loss) |
Schwannoma
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Cutaneous
NF1, associated with HYPERPIGMENTATION Peripheral nerve – solitary or plexiform "shredded carrott" appearance |
Neurofibroma
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AD, Lisch nodules, café au lait spots
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Neurofibromatosis Type I
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AD, 8th nerve schannomas and multiple meningiomas
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Neurofibromatosis Type II
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AD, Hamartomas (Cortical TUBERS)
Benign neoplasms of the brain Seizures liver, kidney, pancreas cysts Angifibromas, shagreen patches, and ASH-LEAF SPOTS |
Tuberous Sclerosis
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AD, Hemangioblastomas
(Cerebellum and Retina) Cysts of liver, pancreas, kidney Renal Cell Carcinoma, Pheochromocytomas |
Von Hippel–Lindau Disease
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