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CNS, Cerebrovascular Dz, 'Plugs&Leaks'
Path Lect. 5
44
Pathology
Professional
01/20/2011

Additional Pathology Flashcards

 


 

Cards

Term

 

Stroke 

(what is it?) 

Definition
constellation of signs & sx: sudden onset, hemiparesis, hemiparalysis, assoc. w/ speech abnls or aphasia and unconsciousness
Term

 

What are the two major categories of stroke? 

Definition

1. hypoxia, ischemia, infarction

 

2. hemorrhage d/t rupture of vessels 

Term

 

Global Cerebral Ischemia 

Definition

 

hypoxia --> hypoxemia --> diffuse hypoxic/ischemia encephalopathy in assoc. w/ severe hypotension --> decr. perfusion ('low flow states) --> global ischemia 

Term

 

Focal Cerebral Ischemia 

Definition

 

Only a portion of the brain is damaged, around vessel area d/t occlusion of a large or small blood vessel

Term

 

Diffuse Encephalomalacia 

Definition

 

Softening and shrinkage and fragmentation of the gray matter combined w/ chalky, white discoloration of the white matter 

Term

 

Acute Neuronal Injury 

Definition
Early micro appearance of the CNS resulting from recent hypoxic-ischemic injury w/ the Dead-Red Neuron being the hallmark 
Term

 

Dead-Red Neuron 

Definition

 

irreversible cell injury indicating coagulation necrosis; shrinkage of entire cell (pyknosis); nucleolus shrinks to an amorphous dot; cytoplasm loses its Nissl material and assumes bright pink/red color 

Term

 

How much time needs to pass before the acute neuronal injury manifests itself? 

Definition

 

@ least 12 hours 

Term

 

What are the 3 main causes of vascular occlusions

Definition

1. thrombosis

2. embolism

3. cerebral edema w/ compression of an artery due to herniation 

Term

 

Ischemic infarct 

(infarct- 48 hrs)

Definition

 

Acute Neuronal injury (Dead-Red Neurons), edema, endothelial swellig and PMN cells 

Term

 

Subacute Phase

(24 hrs-2 weeks)

Definition

Lymphocytic infiltrate, microglia --> macrophages, reactive gliosis w/ gemistocytes

 

Term

 

Phase of repair or resorption 

> 2 weeks 

Definition
Gliosis w/ continued macrophage activity & Cystic cavity
Term

 

Pseudolaminar Necrosis 

Definition

 

Random loss of neurons in the various layers of laminae; damage is not limited to one specific layer 

Term

 

Venous Thrombosis 

Definition

 

Thrombosis to sinus structure, 2nd to infection, dehydration & hypercoaguability. Results in hemorrhagic (red) infarct, in distribution of vein or sinus.

Term

 

Focal Embolism 

Definition

 

Occlusion of a large artery or tributaries by a large fragment (from heart valve, heart tumor) & may contain foreign body. 

Term

 

Paradoxial Embolism 

Definition
Venous thrombus from deep leg veins crosses from venous to arterial circulation via patent foramen ovale in heart --> occlusion of cerebral artery.
Term

 

Global or Shower Embolism 

Definition

 

Release of multiple, small embolic particles arising from bone fractures, which lodge in small vessels [of white matter] --> multiple small hemorrhages, giving it a "flea-bitten" appearance. 

Term

 

Primary and Secondary vasculitis are other causes of infarction & hemorrhage. List a cause(s) of each: 

Definition

 

Systemic Collagen Vascular dz (LE) --> Primary Vasculitis 


Infection (meningitis) --> Secondary Vasculitis  

Term

Cerebral Autosomal-Dominant Arteriopathy w/ Subcortical Infarcts & Leukoencephalopathy 

(CADASIL)

Definition

  • rare hereditary 
  • mutation: NOTCH 3 gene of chromosome 19
  • abnl thickening of CNS vessels --> repeated infarcts of white matter 
  • diffuse, incomplete necrosis of centrum semiovale 

Term

 

Cerebral Amyloid Angiopathy

(a.k.a Congophilic Angiopathy) 

Definition
Abnl deposition of amyloid w/in walls of CNS --> abnl thickening and hyalinization of small vessels --> rupture --> intracerebral hemorrhage 
Term

 

What kind of hemorrhage does HTN cause? 

Definition

 

Intracerebral Intraparenchymal hemorrhages 

Term

 

What are some examples of extraparenchymal hemorrhages? 

Definition

 

epidural, subdural and subarachnoid hemorrhages 

(due to trauma) 

Term

 

What kind of vessels does HTN affect? 

Definition

 

small arteries and arterioles w/ loss of muscular layers and fragility & rupture

Term

 

What parts of the brain does HTN hemorrhages most frequently occur? 

Definition

 

cerebral hemispheres, cerebellum and brain stem 

Term

 

What is the name of the hemorrhages that affect the basal ganglia, esp. the putamen?

Definition

 

Ganglionic Hemorrhages 

Term

 

Where do Lobal Hemorrhages occur? 

Definition

 

Cerebral locations, like centrum semiovale, excluding basal ganglia 

Term

 

Why do old hemorrhages often have a golden-brown discoloration? 

Definition

 

Hemosiderin-laden macrophages (siderophages)

Term

 

Lacunar infarcts 

Definition

 

small, cavitary lesions reflecting areas of small, remote hemorrhage 

Term

 

Binswanger's Dz

Definition
hypoxic-ischemic encephalomalacia related to HTN w/ diffuse areas of incomplete hypox-ischemic necrosis, esp. centrum semiovale
Term

 

 

HTN Encephalopathy 

Definition

 

assoc. w/ severe bouts of malignant hypertension

Term

 

What is the most frequent cause of clinical subarachnoid hemorrhage (SAH)? 

Definition

 

Berry Aneurysms (a.k.a Rupture saccular aneurysms)

Term

 

What is the most frequent cause of non-clinical subarachnoid hemorrhage (SAH)? 

Definition

 

TRAUMA 

Term

 

Where do saccular (berry) aneurysms most usually develop? 

Definition

 

In points of bifurcation in the wall of a congenitally defective major cerebral artery or branches 

Term

 

What is the vessel defect in a saccular (berry) aneurysm? 

Definition

 

absence of the elastica and media, muscular layer --> outpouching into round, thin-wall structure (like a balloon :)

Term

 

What is the most common site of a berry aneurysm? 

Definition

 

Anterior communicating artery 

Term

 

Fusiform Aneurysm 

Definition

 

assoc. w/ atherosclerosis w/ frequen involv. of the basilar artery 

Term

 

Mycotic Aneurysm 

Definition

 

 Results from secondary infection of arterial wall --> wall wkended & ruptures

(NOT specific to fungal infections)

Term

 

Dissecting Aneurysm 

Definition
intimal tear --> dissection of intraluminal blood beneath intima --> extension through the elastica into media or muscular wall of the vessel
Term

 

What kind of vascular malformation do telangiectasias and hemangiomas fall under? 

Definition

 

small vessel or capillary malformation 

Term

 

What kind of vascular malformation do arteriovenous (AV) and venous malformation fall under?

Definition

 

Large vessel malformations

Term

 

What kind of vessels do arteriovenous (AV) malformations have?  

Definition

 

arteries and veins (duh!); vessels can be identified as arteries based on the presence of elastic layer. 

Term

 

Foix-Alajouaine Dz

Definition

 

Spinal Cord Venous malformation, frequently in lower lumbar area --> lesion compress spinal cord tissue --> compression atrophy, ischemia and myelomalacia 

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