“Pseudopalisades,” - central necrosis with surrounding cells on brain Bx, crosses the corpus callosum, vascular proliferation
GBM
Solid tumor with small blue cells, Homer-wright rossettes (halo of cells surrounding central ball), gait instablity, limb ataxia
Medulloblastoma
Rosenthal fibers, spindle cells w/ hair-like glial processes (corkscrew fibers), ataxia, vision loss
Pilocytic astrocytoma
Pseudorosettes (spoke-wheel cells around a blood vessel), rod shaped blepharoplasts, GFAP+, hydrocephalus
Ependymoma
Spindle-shaped cell with concentric whorls, laminated calcifications, tumor on surface of brain
Meningioma
Blue cells, neutrophilic neuritic proceses that stain + for S-100, chromogranin, synaptophysin
Neuroblastoma
Absent cerebellar vermis, global ventricle enlargement, enlargement of posterior fossa
Dandy-Walker
Cerebellar tonsils through foramen magnum, blockage of aqueduct of sylvius, hydrocephalus, apnea, syringomyelia
Arnold-Chiari
Calcifications of white matter in frontal lobes, cells with central nucleus and clear cytoplasm, GFAP +
Oligodendrioglioma
- “chicken wire or fried-egg” appearance
Hemangioblastomas in retina, cerebellum, SC + dermatologic angiomas + RCC, pheo, kidney cysts
Von Hippel-Lindau
Pigmented nodules in iris, optic nerve gliomas, cafe au lait spots
NF-1 (Von Recklinghausen)
Tinnitis in both ears, vertigo, HA, juvenile cataracts, cafe au lait spots
NF-2
Seizures, tram-tracking skull x-ray, facial angioma
Sturge-Weber
Cortical, subependymal hamartomas, acne on face, renal and liver failure, hypopigmented areas, leather-like patch on lower back
Tuberous sclerosis
Kid w/ HA, bitemporal hemianopsia, polyuria, polydipsia, fatigue, weight gain
Craniopharyngioma
Posterior communicating artery rupture
CN III down and out
AICA rupture
IL facial paralysis, pain and temp, tinnitus
PICA
CL Pain and temp body
IL Pain and temp face
Lesion to left motor cortex tract to facial muscles - which muscle is paralyzed?
Right orbicular oris (mouth/smiling muscle)
- occipitofrontalis get B/L innervation
Damage to right MLF, what happens when looking to the left?
Fixed R eye, nystagmus in left
- nystagmus in ABducting eye = signal to CN III is lost
Inc Hct, foamy cells with inc vascularity, cerebellar mass in an adult
Hemangioblastoma
Paralysis in left leg, atrophy, areflexia
Polio
Paralysis in lower limbs, arms, hyperreflexia, no sensory loss
ALS
- anterior horn and CST –> UMN (vs. polio and GBS)
Paralysis in both legs, elevated protein in CSF with normal cells, absent DTRs
GBS