Card Set Information
Integrity of blood brain barrier is disrupted
causing interstitial edema
increase in intracellular fluid from
medial aspect of the temporal lobe compressed
against the tentorum, third nerve compressed resulting in pupillary dilation on
the side of the lesion
unilateral expansion of cerebral hemisphere displaces the cingulate gyrus under the falx cerebri
Cingulate gyrus herniation
Cerebellar tonsil displaces through the foramen magnum, brain stem compression of respiratory centers
Most life threatening
Prevent by medicine, holes in skulls
Midline and pons, due to brain herniation thru
the foramen magnum. Vessels tear, almost always lethal, also VERY serious.
Causes of Duret's hemorrhage
Subdural hematoma, tumor, trauma
Most common cause of CVA
Most common populatino for an infarct
Most common cause of an infarct
Type of necrosis involved with an infarct
Vessel most commonly causing an infarct
What type of reactions occur at the MCA?
Gliotic reactions, NOT fibrosis
Most common cause of primary brain parenchymal hemorrhage
minute aneurysms in basal ganglia from
Charcot-Bouchard microaneurysms; seen in primary brain parenchymal hemorrhage
Most common location for a parenchymal hemorrhage
Basal ganglia (particularly putamen)
Parenchymal hemorrhage sx
N,V,HA,LOC, speech problems
Most common cause of SAH
rupture of a saccular aneurysm
Where are most berry aneurysms located and when is the greatest risk of rupture?
most commonly found at arterial bifurcations, such as junction of anterior cerebral and anterior communication arteries
Greatest risk of rupture 4-7 cm in diameter
Who is at an increased risk for developing renal aneurysms?
What are the most common vascular malformations?
AV malformations are most commonly found where?
The cerebral hemisphere, typically temporal lobe
haphazardly arranged blood vessels
Most common areas of bleeding in the brain
SAH, epidural, subdural
Most common cause of epidural hematoma
Hematoma associated with skull fracture
Hematoma associated with MMA
Hematoma with venous blood
MOA of subdural hematoma
Brain bouncing around and pulling on BRIDGING veins
Brain injury associated with rapid deceleration and retraction and shearing of axons
Diffuse axonal injury
What is the difference between the two types of brain contusions?
Coup-injury to vein directly beneath and impact sight. Usu. Stationary head being hit by a moving object
o Contra-coup-opposite, moving head hitting astationary object.
Optic nerve sheath damage and retinal hemorrhage are signs of what?
Shaken baby syndrome
What brain injury results due to shearing forces, such as being punched in back of head, or karate chop to back of neck?
Vertebral artery laceration
Most common cause of neonatal meningitis
Group B Strep, e coli
Most common cause of meningitis in >6mo
H flu (but not anymore due to vaccination, it's now strep pneumo
Most common cause of meningitis in older children, adolescents, young adults
Most common cause of meningitis in older adults
What populations do you find listeria monocytogenes in?
elderly, neonates, and immunocompromised
Purulent exudate at base of brain in haemophilus influenzae infections obscuring circle of willis
H flu meningitis
Edematous brain and spinal cord with neutrophils and fibrin
Increased protein and decreased glucose in CSF
Most common viruses causing viral meningitis
mumps, echovirus, coxsachievirus
CSF: protein slightly elevated, glucose normal, mostly lymphocytes
Most comon causes of chronic meningitis
CSF: protein slightly elevated, glucose normal
most common locations for a brain abscess
Occur usually in the cerebral hemispheres, Temporal lobe, frontal lobes (niddle ear and sinus involvement)
multiple focal lesions in the gray matter
Perivascular inflammation: lymphocytes, plasma cells
infects oligodendroglia causing areas of demyelination
Progressive multifocal leukoencephalopathy
Where in the brain does HSV infect in vira encephalitis?
Temporal lobes and orbital/frontal areas
Where in the brain does CMV affect in viral encephalitis?
Ependymal surfaces (lining of the ventricles)
Where in the brain does HIV affect in viral encehpalitis?
Brain atrophy, involvement of white matter and basal ganglia with multinucleated giant cells
Causes of spongiform encephalopathies
CJD, kuru, mad cow dz
Vacuoles in gray matter with rapidly progressive dementia, gait abnormalities
Most common demyelinating disease
Most common age affected with MS
Common sites for plaques in MS
periventricular white matter, optic nerves, white matter of spinal cord
Visual disturbances, paresthesias, spasticity, speech disturbances, and gait abnormalities
Butterfly wing-red area
Thiamine deficiency resulting in peripheral
Rapid onset of confusion, paralysis of
extraocular muscles and ataxia
Hemorrhage in mammilary bodies, thalamus, gray matter around the cerebral aqueduct
What results from untreated Wernickes?
Inability to form new memories or retrieve old ones
Accompanied by confabulation-forget parts of the story and will fill in with s/t else, won’t make sense
Technically can only be dx after death
Most common cause of dementia in elderly
Hydrocephalus ex vacuo: dilation of ventricles from loss of parenchyma
What brain weight is an indication of Alzheimers?
coarse, tortuous neurites in cerebral cortex with a central amyloid core
Senile plaques, seen with Alzheimers
filamentous aggregates within cytoplasm of neurons
Neurofibrillary tangles, seen with Alzheimer's Disease
Substantia nigra and locus ceruleus are depigmented in most cases
laminated intracytoplasmic inclusions in some neurons
Lewy bodies, seen with Parkinsons
Involves extrapyramidal motor system
Atrophy of caudate nucleus, putamen, and globus pallidus; Dilation of ventricles; Neuropsychiatric disturbances occur; Increased risk of suicide
Degenerative disorder involving the upper and lower motor neurons of the pyramidal system
Most common cause of death in ALS
pneumonia, followed by respiratory insufficiency or infections