CNS

Question 1

• shrinkage of cell body
• ## pyknosis of the nucleusdisappearance of the nucleolus
• loss of Nissl substance,
  intense cytoplasmic eosinophilia

Answer 1

Acute injury: “Red Neurons”

Question 2

Loss of synapses → cell death and reactive gliosis

Answer 2

SUBACUTE AND CHRONIC INJURY: “DEGENERATION”

Question 3

hypertrophy and hyperplasia response to injury

Answer 3

ASTROCYTES

Question 4

• proliferate
• develop elongated nuclei
• form aggregates around small foci of tissue necrosis (microglial nodules)
• congregate around cell bodies of dying neurons (neuronophagia)

Answer 4

MICROGLIA

Question 5

Excess fluid accumulation in the brain parenchyma

Answer 5

Cerebral edema

Question 6

Pathyway of Cerebral edema
in which there is an↑ in ECF and vascular permeability → ↑ intercellular fluid
Conditions include:
Localized: adjacent to inflammation and neoplasm
Generalized: global ischemic injury

Answer 6

Vasogenic

Question 7

• Excess fluid accumulation in the ventricular system
• Mostly due to impaired flow and resorption of CSF
• Rarely due to CSF overproduction secondary to tumors
• Increased volume of CSF expands the ventricles and can elevate the intracranial pressure
• When hydrocephalus occurs before cranial suture closure, the head is enlarged; hydrocephalus after bone fusion leads to ventricular expansion and increased intracranial pressure without a change in head circumference

Answer 7

Hydrocephalus

Question 8

Pathway of Cerebral Edema in which there is ↑ intracellular fluid due to cell membrane injury
Conditions include:
Generalized hypoxic ischemic injury
Metabolic derangement

Answer 8

CYTOTOXIC

Question 9

A focally obstruted ventricular system that is caused from mass in the 3rd ventricle and aqueductal stenosis

Answer 9

NON-COMMUNICATING
(OBSTRUCTIVE) HYDROCEPHALUS

Question 10

It is a ventricular system communicate with subarachnoid space and enlargement of entire ventricular system that si caused from CSF overproduction due to choroid plexus tumor and arachnoid fibrosis due to minigitis

Answer 10

COMMUNICATING HYDROCEPHALUS

Question 11

There is an↑ CSF as compensation to decreased parenchymal mass

Answer 11

HYDROCEPHALUS EX VACUO

Question 12

Displacement of brain tissue past rigid dural folds (the falx and tentorium) or through openings in the skull because of increased intracranial pressure

Answer 12

Herniation

Question 13

↑ intracranial ____ → ↑ intracranial ____ → herniation

Answer 13

• volume

- pressure

Question 14

The herniating part is cingulate gyrus and the hernation is under the falx cerebri. The compressed structures are the anterior cerebral artery and branches which produces secondary infarcts (focal neurologic deficits)

Answer 14

SUBFALCINE (CINGULATE) HERNIATION

Question 15

The herniating part is medial aspect of temporal lobe and the hernation is across tentorium cerebelli. The compressed structures are the CN III; posterior cerebral artery; contralateral cerebral peduncle which produces CN III: Pupillary dilation; posterior cerebral artery: territorial infrct; contralateral cerebral peduncle: hemiparesis ipsilateral to lesion; and Duret hemorrhages.

Answer 15

TRANSTENTORIAL HERNIATION

Question 16

The herniating part is cerebellar tonsils and the hernation is through foramen magnum. The compressed structure is the brainstem which produces cardiac and respiratory depression

Answer 16

TONSILLAR HERNIATION

Question 17

• Failure of the closure of anterior neural tube
• Absence of most of brain and calvarium
• Area cerebrovasculosa: flattened remnant of disorganized brain tissue

Answer 17

Anencephaly

Question 18

• Extension of the spinal cord and meninges through a defect in vertebral column
• Meningocele: meninges only

Answer 18

Myelomeningocele

Question 19

• Diverticulum of a malformed brain tissue through a defect in the cranium
• Usually in the posterior fossa
• Can occur across cribriform plate in anterior fossa

Answer 19

Encephalocele

Question 20

Asymptomatic bony defect (spina bifida occulta) to a severe malformation with a flattened disorganized spinal cord segment associated with an overlying meningeal outpouching

Answer 20

Spina bifida

Question 21

Small brain; associated with chromosome abnormalities, fetal alcohol syndrome, and viral infection acquired in utero (HIV-1)

Answer 21

Microencephaly

Question 22

Large brain

Answer 22

Megalencephaly

Question 23

Decreased number of gyri

Answer 23

Lissencephaly

Question 24

Complete absence of gyri

Answer 24

Agyria

Question 25

numerous small, irregularly formed cerebral convolutions

Answer 25

Polymicrogyria

Question 26

abnormal clusters of neurons in inappropriate locations along normal migratory routes; they are commonly associated with epilepsy

Answer 26

Neuronal heterotopias

Question 27

incomplete separation of the cerebral hemispheres; associated with midline facial abnormalities (cyclopia)

Answer 27

Holoprosencephaly

Question 28

absent white matter bundles

Answer 28

Agenesis of the corpus callosum

Question 29

small posterior fossa with misshapen cerebellar tonsils which shows Hydrocephalus; lumbar myelomeningocele

Answer 29

C

Question 30

low-lying cerebellar tonsils extending into the vertebral canal which is Clinically silent or present with CSF flow obstruction

Answer 30

Chiari type I malformation

Question 31

enlarged posterior fossa; absent cerebellar vermis; cystic dilatation of the 4th ventricle which shows Brainstem nuclei dysplasias

Answer 31

Dandy-Walker malformation

Question 32

- Hypoplasia of cerebellar vermis with misshapen brainstem | - “molar tooth sign” on imaging

Answer 32

Joubert syndrome

Question 33

Nonprogressive neurologic motor deficits (dystonia, spasticity, ataxia/athetosis, paresis) occurring during prenatal and perinatal periods

Answer 33

Cerebral palsy

Question 34

occurs between the thalamus and caudate nucleus; may remain small and localized or can extend into the ventricular system

Answer 34

Germinal matrix haemorrhage

Question 35

supratentorial periventricular white matter ischemic infarcts

Answer 35

Periventricular leukomalacia

Question 36

cystic lesions throughout cerebral hemispheres in extensive ischemic damage; involves both gray and white matter

Answer 36

Multicystic encephalopathy

Question 37

mushroom-shaped gyri with thinned-out, gliotic stalks

Answer 37

Ulegyria

Question 38

ischemic neuronal loss and gliosis in the basal ganglia and thalamus associated with aberrant and irregular myelin formation

Answer 38

Status marmoratus

Question 39

- displaced skull fracture: fracture in which bone is displaced into the cranial cavity by a distance greater than the thickness of the bone - Accidental falls tend to involve the occiput - Trauma occurring as a consequence of syncope tends to involve the frontal skull

Answer 39

Trauma: Skull Fracture

Question 40

clinical syndrome of altered consciousness secondary to head injury

Answer 40

CONCUSSION

Question 41

old traumatic lesions present as depressed, retracted, yellowish brown patches involving the ___

Answer 41

crests of gyri (plaque jaune)

Question 42

Findings: axonal swelling About half of patients who develop coma shortly post-trauma

Answer 42

DIFFUSE AXONAL INJURY

Question 43

- Usually associated with skull fracture (in adults) - accumulation of arterial blood between the dura and the skull - rapidly evolving neurologic symptoms (often after a short lucid period) that require intervention

Answer 43

EPIDURAL HEMATOMA

Question 44

- May follow minor trauma - accumulation of venous blood between the dura and the arachnoid - slowly evolving neurologic symptoms, often with a delay from the time of injury

Answer 44

SUBDURAL HEMATOMA

Question 45

Spinal Cord Injury: with lesions at C4 and above, respiratory compromise due to diaphragm paralysis

Answer 45

Cervical vertebrae: quadriplegia

Question 46

Thoracic vertebrae or below Spinal Cord injury

Answer 46

paraplegia