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What's the gross feature of an astrocytoma?
Poorly defined, soft, pale expansile mass
What's the characteristic histology pattern of Anaplastic astrocytoma?
Hipercellularity, pleomorphism, mitoses, cellular atypia
What's the prognosis for anaplastic astrocytoma?
2 year survival post surgery/therapy
What are the characteristic features of a pilocytic astrocytoma? What's the demographic/prognosis?
- Non-infiltrative growth in posterior fossa
- Most common in kids
- Excellent prognosis
What's the prognosis for a grade 4 astrocytoma?
Mean survival 15 months
What genetic alterations are associated with astrocytomas? (Low/High Grade)
- Low: Inactivation of p53, overexpression of PDGF-A
- High: Disruption of RB, p16/CDKNZA, chromosome 19
What are genetic alterations associated with grade 4 astrocytoma?
1/3 p53, 1/3 EGFR, 1/3 neither
In which astrocytoma is necrosis present?
What are histological characteristics of brain metatsasis?
Multiple lesions, well demarcated, spherical
What's the gross charactersitic of a gliblastoma?
Ill defined, large, hemorrhagic, necrotic mass
What are symptoms charactersitic of a uncal herniation?
Fiked and dilated pupil
What are histological characteristics of glioblastoma?
Hyperceullarity, mitoses, endothelial hyperplasia, coagulatice necrosis surrounded byu pseudopalisading/ serpintine necrosis
What's the most common primary brain tumor of adults?
What's the gross features of a meningioma? Where's their typical location?
Mass projecting from inner surface of dura; usually found in the parasagittal sinus
What would you suspect if there were multiple meningiomas?
- Von Recklinghausen's neurofibromatosis
- Chromosome 22 mutations (NF2)
What's the histoilogical pattern seen in meningioma?
Whorled growth patten with psammoma bodies
What's the demographic for meningioma (spinal)?
- Females 3:2 in mid-late life
- Spinal = 10:1
In what conditions are Psammoma bodies present?
- Papillary carcinoma of thyroid
- Serious cystadenocarcinoma of ovary
What ares of brain are most vulnerable to infarction?
- Basal ganglia and internal capsule
- Ends of MCA
What are recent/old sings of brain infrarction?
- Recent infarct: dead reds --> gitter cells
- Old infarct: cystic with scattered macrophages and vessels (areas of gliosis)
What's the causes of thrombotic vs. Embolic occlusions?
- Thrombotic: atherosclerosis in carotid/vertebrobasila system
- Embolic: mural thrombus --> MCP
What's most common cause of primary intracebral hemorrhage? (type/location)
- (Rupture of vessel)
- Charcot-Bouchard microaneurysm (HTN) in basal ganglia/thalamus
What are signs of UMN/LMN injury?
- LMN: muscle atrophy and fasciculations
- UMN: hyperreflexia and Babinski sign
What are areas of involvement in ALS?
- UMN/LMN symptoms on upper/lower extremities, tongue/facial muscles, chewing/swallowing
- Sensory/ocular/ingelligence maintained
What's the cause of fasiculations in ALS?
- ACh receptors become distributed over whole muscle fiber surface
- Small amounts of ACh propagate AP
What's the most common demographic for ALS?
60 year old male (2:1)
What's the most common from of motor neuron disease in adults?
What's the genetic abnormality in ALS?
SOD1 gene on chromosome 21 (10% familial)
What are gross intracranial characteristics of ALS?
Thinning of precentral gyrus -> widening of central sulcus
What are characteristics of the spinal cord in ALS?
- UMN: lateral corticospinal tracts
- LMN: anterior horn
What are common clinical symptoms of dementia?
Gradual cognitive loss and alteration of behavior
What's a Neurofibrillary tangle?
- Cytoplasmic bihelical filaments of abnormal proteins
- (tau, ubiquitin)
What are Neuritic Plaques?
focal collection of tortuous neuritic processes surrounding an amyloid core
What type of Amyloid is involved in Azheimer's Disease?
B protein from APP (chomosome 21)
What forms first? Neuritic processes or amyloid core?
Neuritic processes form first
What are morphological features of alzheimer's disease?
- 1.Cortical atrophy
- 2.Neuronal degeneration/destruction
- 3.Neurofibrillary tangles
- 4.Neuritic plaques
- 5.Amyloid vasculopathy
What are the areas of atrophic involvement in alzheimer's disease?
Frontal, parietal, temporal
Where is the most prominent neuronal loss in Alzheimer's disease?
- Cerebral cortex, amygdala, hippocampus and basal
- forebrain (basal nucleus of Meynert).
What's the normal size of an atrophic alzheimer's brain?
Less than 1100g
What hemorrhagic condition is associated with cortial atrophy?
- Chronic subdural hematoma
- Increased range of motion for bridging vein rupture
What are charactersitics of Pick Disease?
- Less frequent
- Frontal/anterior 1/3 temporal lobe atrophy
- Pick's bodies
What are pick's bodies?
bsophilic cytoplasmic inclusions of tau/ubiquitin protein
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