Neuropathology — Flashcards

Flashcard 1: What is the term for infarcted tissue in the basal ganglia or internal capsule caused by occlusion of a lenticulostriate artery?

Answer: lacunar infarct

Flashcard 2: epidural hematoma

Answer: rupture of middle meningeal artery; fracture of temporal bone

Extra: rapid arterial bleedinglucid interval followed by decreased LOC; CN 3 palsy, increased ICPCT: biconvex, hyperdense blood; does not cross sutures; may cross falx, tentorium 

Flashcard 3: What is the cause of central pontine myelinolysis?

Answer: Often iatrogenic; caused by rapid correction of chronic hyponatremia.

Extra: - Pathogenesis: Massive axonal demyelination of pontine white matter tracts. - Clinical Features: Acute paralysis, dysarthria, dysphagia, diplopia, loss of consciousness; may progress to locked-in syndrome. - MRI (T2): Increased signal (hyperintensity) in the central pons. - Mnemonic: "From Low to High (Sodrum), your Pons will Die."

Flashcard 4: Which vessel is ruptured in a Subdural Hematoma?

Answer: Bridging veins rupture (crescent-shaped on CT)

Extra: Mechanism: Slow venous bleeding via rupture of bridging veins. Clinical: Decreased LOC, increased ICP. CT findings: Crescent-shaped, hyperdense blood (in acute phase); crosses suture lines; does not cross dural attachments (falx, tentorium). Risk factors: Brain atrophy, elderly, alcoholics, shaken baby syndrome.

Flashcard 5: Classic clinical presentation of subarachnoid hemorrhage?

Answer: "Worst headache of my life" (Thunderclap headache)

Extra: - Cause: Rapid arterial bleeding, most commonly from rupture of a berry (saccular) aneurysm. - Symptoms: Decreased LOC, increased ICP, meningismus. - Diagnosis: - CT: Blood in cisterns and gyri. - Lumbar Puncture: Bloody or xanthochromic (yellow) CSF. - Complications: Late-onset vasospasm (3–10 days later); Nimodipine is used for prevention. - Risk of rebleeding.

Flashcard 6: Key features of intraparenchymal hemorrhage (CT and etiology)

Answer: CT: Smudgy, patchy blood within parenchyma (typically in basal ganglia and internal capsule) :: Most common causes are HTN and Amyloid Angiopathy

Extra: Etiology: Hypertension (most common overall, often in basal ganglia), Cerebral Amyloid Angiopathy (most common in elderly with lobar hemorrhage), vasculitis, or neoplasms.

Flashcard 7: How long after ischemic brain injury until red neurons appear?

Answer: 12-48 hours

Flashcard 8: How long after ischemic brain injury until necrosis and neutrophils appear?

Answer: 24-72 hours

Flashcard 9: How long after ischemic brain injury until macrophages appear?

Answer: 3-5 days

Flashcard 10: How long after ischemic brain injury until reactive gliosis and vascular proliferation is evident?

Answer: 1-2 weeks