Dura, Pia, CSF
Arachnoid, Pia, Blood
Pia, Arachnoid, CSF
Dura, Arachnoid, CSF
Inflammation of the Pia
Usually a consequence of traumatic brain injury.
The arachnoid acts as a barrier to infection.
The inflammation is restricted to the outer surface of the brain.
E. Coli and Group B strep are most commonly found in neonates with bacterial meningitis
Group A strep and H. Pylori are most commonly found in adolescents with bacterial meningitis.
H. influenza is usually fuond in infants 3 months-3 years old with bacterial meningitis.
Strep pneumococcus is usually found in adults with bacterial meningitis.
N. meningitidis is usually found in military barracks when bacterial meningitis is going around.
PMN's in the CSF
PMN's in the blood
RBC's in the CSF
Purulent discharge in the ears
Elevated white count
Pia, creamy or white
Arachnoid, yellow or purulent
Arachnoid, creamy or white
Dura, Yellow or purulent
Arachnoid, grey or cloudy
Convulsions in adults
If untreated, coma and death
Most commonly occurs in white males
Typically effects those in the 6th-8th decade of their life.
Genetic factors do not play a role (except for a rare autosomal dominant disorder)
The vast majority of cases are idiopathic.
The disease has been recorded after viral encephalitis and after the intake of a toxic chemical (MPTP).
Brain stem, sympathetic chain, adrenergic
Cerebral cortex, cranial nerves, muscarinic
Substantia Nigra, basal ganglia, dopaminergic
Prefrontal cortex, afferent neurons, cholinergic
Medulla oblongota, efferent neurons, achetylcholinestergic
Von Economo Encephalitis
Loss of pigmentation in the substantia nigra
Residual atrophic nerve cells are seen known as "Hewey Bodies"
Pigmented neurons are scarce with small extracellular deposits of melanin, from necrotic neurons.
Loss of pigmentation in the Locus Ceruleus
Rod-shaped, smooth, basophilic mitochondrial inclusions.
Spherical, granular, eosinophilic cytoplasmic inclusions.
Square, gritty, lymphocytic periplasmic inclusions.
Triangular, soft, macrolytic endoplasmic inclusions.
Spider bites (black widow, tunnel spider)
Drugs (Phenothiazines, Haldol)
Poison (Carbon monoxide, Manganese)
Tumors (Near the basal ganglia)
Acute Hemorrhagic Meningitis
Advances of our pathologic understanding of AD relate to alpha-protein amyloid deposition in senile plaques.
Plaques located in the spinal cord are linked to intelectual funciton and are a constant feature of AD
Beta protein amyloid is found in the walls of the cerebral vessels may be the origin of deposits found in the brain in AD.
The pathogenisis of AD is fully understood
World wide, AD is the least common cause of dementia in the elderly, accounting for less than half of all the cases.
Pleated, macrotubule-associated, lipid
Helical, microtubule-associated, axonal
Round, cytoskeletal-associated, active
Helical, macrotubule-associated, lipid
Loss of neurons and neuritic processes
Unilateral cortical atrophy
Atrophy in frontal, parietal, temporal, and hippocampal cortices.
Signet ring cells
Senile (neuritic) plaques
Hyppocampus, amygdala, and cortex
Medulla, corpus colosum, hyppocampus
Cortex, brain stem, spinal cord
Frontal, temporal, parietal lobe
Amyloid angiopathy, Congo red stain, spinal cord
Amyloid angiopathy, Congo red stain, cerebral blood vessels.
Neurofibrillary tangles, congo red stain, cerebral cortex
Senile plaque, Silver stain, cerebral blood vessels
Amyloid angiopathy, silver stain, cerebral blood vessels
Pathologic examination of vessels in the brain
Pathologic examination of brain tissue
A chronic demyelinating disease of the CNS
Characterized by numerous patches of demyelination througout the grey matter
It is the most common demyelinating disorder (prevelence 1 in 1000)
Disease effects both sensory and motor functions
Characterized by exacerbations and remissions over a period of years.
Most common in 40 year olds (uncommon before 14 and after 60 y.o.)
Women afflicted twice as often as men
Possibly other infectious, genetic, and infectious etiology
A familial aggregation of the disease with an increased risk in 1st degree relatives.
Dizygotic twins show a 25% concordance for MS (2% for monozygotic)
Immune factors related to perivascular lymphocytes and macrophages with numerous CD4+, CD8+, and t-cells
Direct evidence exists for the involvement of certain viruses including mumps, rubella, herpes, and measles.
JC virus has recently been studied, due to its role in preventing demyelination in the CNS.
The plaque is the hallmark of the disease
Usually situated in the white matter, but occassionaly breech the gray-white junction
Exhibit a preference for the optic nerves and chiasm and uniformly localizes in to the periventricular white matter.
Can also involve the cerebellum, brainstem, and spinal cord.
Usually 2-4 mm in size with a jagged, irregular contour
Histologically, there is a selective loss of myelin in a region of axonal preservation.
Perivascular inflammation lymophocytes and macrophages with focal edema.
Astrocytes traverse the aging plaque and the tissue becomes dense with glial processes.
As the plaque ages, it becomes less discrete and the edema progresses.
A lesion at the optic nerve
A plaque in the brain stem
A plaque within the spinal cord
A lesion at the substantia nigra
A plaque within the basal ganglia
Severe nausea and vomiting
Severe visual defects
Incontincence and dementia