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Disorders affecting brain​

  1. Neurons: IHC marks → neurofilament protein, NSE (neuron specific enolase), synaptophysin.
  2. Glia → derived from neuroectoderm (marcroglia astrocytes, oligodendroctes,  ependyma)
    → derived from bone narrow (microglia)
Cerebral Edema:
3 types Q
  1. Vasogenic oedema:
  1. Integrity of normal BBB is disrupted Q
  2. Fluid in intercellular space
  3. Localized (adj. To abscess and neoplasm) or generalized
  4. White matter more affected
  1. Cytotoxic: Oedema:
  1. ↑ in intracellular fluid sec. to cellular injury Q
  2. e. g. generalized hypoxic/Ischemic insult.
  1. Interstitial Oedema (hydrocephalic oedema):
  1. Especially around lateral ventrieles
  2. Abnormal Flow of fluid intraventricular CSF to periventricular white matter in setting of hydrocephalus
Cerebral Herniation
Raised Intra cranial pressure: Q
  1. In mean CSF pressure > 200 mm H2O with patient recumbent
  2. Associated conditions: herniations
Subfalcine (cingulated gyrus): Q
  1. Occurs when unilateral on asymmetric expansion of cerebral hemispheres
  2. Associated with compression of branches of anterior cerebral artery.
Transtentorial herniation:- Q
Medial aspect of temporal lobe compressed against free margin of tentorium cerebelli
III. Cranial Nerve is compressed → papillary dilation
- Compression of posterior cerebral artery
Progressions → hemorrhagic lesions in mid brains & pons.
Tonsillar herniation, Displacement of cerebral tonsil through foramen magnum. Brain steum compression, life threatening.
Developmental Abnormalities of Brain
Posterior fossa anomalies
  1. Arnold - Chiari Malformation (Chiari type II malformation). Small posterior fossea  Q, misshaped midline cerebellum with down ward extension of vermis, also seen with hydrocephalous & lumbar myelomeningocele
  2. Other ass. changes: caudal displacement of medullar malformation of tectum, aguedoctal stenosis, cerebral heterotopias, hydromyelia
Chiari I malformation:
Low lying cerebral tonsils, extend down vertebral canal, may cause symptoms de to obstruction of CSF flow & medullary Comp., that are amenable to neuro intervention.

Dandy - walker malformation: enlarged posterior Fossa cerebral vermis absent or rudimentary

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