T2 Nishiyama Cerebral Edema

Front 1

Hydromelia

Back 1

Hydromelia: dilatation of central canal of spinal cord

Front 2

Syringomyelia

Back 2

Syringomyelia: formation of cavity unconnected to central canal, associated with vertebral fusions, scoliosis, platybasia

Front 3

Syringobulbia:

Back 3

Syringobulbia: same as syringomyelia, but involving the brainstem.

Front 4

Cerebral Palsy

Back 4

Perinatal Brain Injury - “Cerebral palsy”: non-progressive neurologic motor deficits, spasticity, dystonia, ataxia. Deficits attributed to insults during prenatal & perinatal periods. Deficits may develop after the prenatal period. Pathologic exams: no specific changes, may show remote changes of hemorrhage.

Front 5

Parenchymal Hemorrhage.

Back 5

Premature infants, increased risk of such hemorrhage. In germinal matrix, often near junction of thalamus and caudate nucleus (explains why pt have motor deficit). Hemorrhage may remain localized or extend to ventricular system and to subarachnoid space, causing hydrocephalus

Front 6

Periventricular Leukomalacia

Back 6

Especially in premature infants, infarcts. May occur in supratentorial periventricular white matter. Necrosis is followed by calcification & appear as chalky yellow plaques. When both gray & white matter are involved, large cystic lesions develop in cerebral hemispheres (multicystic encephalopathy) [Nishi skipped]

Front 7

Ulgyria

Back 7

Thin, gliotic gyri caused by ischemic lesions deep in sulci

Front 8

Status Mamoratus.

Back 8

Marble-like appearance to deep nuclei in basal ganglia & thalamus. Because of above, choreoathetosis & related movements may be clinical sequalae [Nishi skipped]

Front 9

Epidural hematoma.

Back 9

Dura in skull is closely adherent to overlying bone & periosteum, there is a potential space between dura & periosteum. Coursing through is the middle meningeal artery. Trauma to skull may cause bleeding into the potential space & cause epidural hematoma. Clinically, pt can be lucid for several hours before onset of neurologic signs. Hematoma may form & expand rapidly, treatment of draining the blood is a medical emergency

Front 10

Subdural Hematoma.

Back 10

Potential space exists between dura & leptomeninges covering the brain. Bridging veins course through this space, the cause in most cases is rupture of bridging veins. Displacement of brain during trauma tear veins at point they penetrate dura. Infants susceptible to develop such hematomas, veins are thin-walled. Older pts with atrophy of brains give brain more leeway & results in increased incidence of such hematomas.

Front 11

What would be the chronologic sequence of events in a subdural hematoma?

Back 11

Subdural hematomas are organized like hematomas in other parts of body. Chronologic sequence of events: 1. Lysis of clot (about 1 week), 2. Growth of fibroblasts into clot, fibroblasts derived from dura (2 weeks), 3. Early development of hyalinized connective tissue (1-3 months)

Front 12

Explain the gross morphology of the Subdural Hematoma.

Back 12

Gross: acutely, blood clot over surface of brain over the adherent dura. Organized hematoma: firmly attached to inner surface of dura by fibrous tissue, surface of brain is spared. Chronic subdural hematoma, term applied to organized hematomas. Multiple hematomas not rare, risk of rebleeding is greatest in first few months after initial hemorrhage.