Neurodegenerative & Demyelinating Diseases, Trauma, Vascular Disorder & Tumors

Flashcards about Neurodegenerative & Demyelinating Diseases, Trauma, Vascular Disorder & Tumors

Concussion

Clinical syndrome of altered mental status secondary to head injury, potentially involving loss of consciousness, temporary respiratory arrest, and loss of reflexes.

Contusion

Direct parenchymal injury to the brain, which includes Coup injury (at the point of impact) and Contrecoup injury (opposite to the point of impact).

Diffuse Axonal Injury

Injury to white matter with axonal swelling; locations include the corpus callosum, periventricular white matter, and hippocampus.

Cerebral Edema

Accumulation of excess fluid within the brain parenchyma.

Vasogenic Edema

Occurs when the integrity of the normal blood-brain barrier is disrupted, leading to increased vascular permeability.

Cytotoxic Edema

Increase in intracellular fluid secondary to neuronal and glial cell membrane injury.

Functional Hypoxia

Low partial pressure of oxygen, (high altitude )impaired oxygen-carrying capacity, (anemia,CO poisoning)or inhibition of oxygen use by tissue.(cyanide poisoning)

TIA

Transient ischemic attack - due to small platelet thrombi or atheroemboli

Stroke

Acute-onset neurologic deficits resulting from hemorrhagic or obstructive vascular lesions.

Global Cerebral Ischemia (Diffuse Ischemic Encephalopathy)

Widespread ischemic-hypoxic injury from severe systemic hypotension.

Border Zone (Watershed) Infarcts

Areas of infarction in regions of the brain and spinal cord that lie at the most distal portions of arterial territories; often seen after hypotensive episodes.

Focal Cerebral Ischemia

Cerebral arterial occlusion leads first to focal ischemia and then to infarction in the distribution of the compromised vessel.

Lacunar Infarcts

Small infarcts in deep non-cortical white matter or brainstem resulting from the occlusion of penetrating branches of cerebral arteries. (Cerebral small vessel disease is most commonly related to age and hypertension)

Epidural hematoma

Between skull and dura

affects the middle meningeal artery

2ry to tempoparital fracture

Lucid interval before a loss of consciousness talk and die syndrome,

Trans Tentorial herniation.

bi convex shaped hemorrhage that does not cross suture line

Subdural hematoma

Tear of the bridging veins drain the brain to dural sinuses

Risk factors

Brain atrophy

Anticoagulants therapy

Shaking,whiplash

Symptoms slow venous, bleeding with delayed onset of gradually increasing headache and confusion

Crescent shaped hemorrhage that crosses, suture lines the gyri are preserved since pressure is distributed equally

Cannot cross falx tentorium

Multi-infarct dementia

Cerebral artery sclerosis present as a slow step wise, decreased in mental function important to distinguish from Alzheimer’s and other causes of dementia

Cerebral edema gross

The edematous brain is softer and appears over fill the cranial vault and generalized edema the gyri Are flattened as a result of compression of expanding brain by Dura matter and inner surface of the skull and the inverting sulci are narrowed and ventricular cavities are compressed

Global cerebral ischemia clinical

If mild insults, there may be only a transient post-ischemic confusion state with eventually complete recovery neurons are more susceptible to hypoxic injury then gillial cells, and the most susceptible neurons are the perimeter cells of hippocampus , and the cortex and per purkinje cells of the cerebellum

In severe insult, widespread neuronal, death occurs irrespective of regional vulnerability patients who survive often remain severely, impaired neurologically, and in persistent vegetative state other patients meet the clinical criteria for brain death when patient with this form of irreversible injury are maintained on mechanical ventilation the brain gradually undergoes autolysis, resulting in so-called respirator brain

Global cerebral ischemia morphology

Brain is swollen, white gyri Narrow sulci

Cut surface has poor demarcation between gray and white matter

Neuronal loss, gliosis in neocortex is uneven with preservation of some layers and devastation of other pattern termed pseudo laminar necrosis

Also border zone in fact, check it out

Thrombotic occlusion

Most frequently in carotid artery or cerebral archery the result of atherosis and rarely from arthritis

Embolic arterial Occlusion

Drive from the heart most often from murals from Moses, complicating myocardial infarction from atrial fibrillation and endocarditis

Venous occlusion

Zero good communication of cerebral venous drainage could take place in cancers due to increase predisposition through thrombosis superior side of thrombosis, mainly to bilateral parasagittal multiple hemorrhagic infarcts

Not occlusive causes

Compression of cerebral arteries from outside, such as during herniation