©FYNDLAY.
PA3306 Mod 10 Neuropathology Exam Study
Guide.
Neurologic Symptoms - Answers✔Headache
Abnormal Reflexes
Neck stiffness
Headache: Intracranial causes vs Extracranial causes - Answers✔Intracranial:
-Raised IC pressure
-Constriction and dilation of IC vessels (migraine)
-Irritation or inflammation of meninges
Extra-cranial:
-Referral
-GCT arteritis
Exaggerated vs. Impaired reflexes - Answers✔Exaggerated
-UMN CST lesion
Impaired:
-LMN CST lesion
-Compression of motor nerve roots
-Peripheral neuropathy
Reactions of Neurons to injury - Answers✔Acute - anaerobic of glucose depleted
Chronic - accumulation of abnormal proteins (aggregates) --> degenerative disorders of the brain
1
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High sensitivity to oxygen starvation --> Inability to generate AP
Neuronal life span
Accumulation of misfolded proteins (proteinopathies)
Acute Neuronal Injury - Answers✔Red Neurons* (earliest marker of neuronal cell death- can see
by 12-24 hours post insult)
Morphologic features:
-Shrinkage cell body
-Pyknosis nucleus
-disappearance of nucleosus
-loss of nissl substance
-intense eosinophilia of the cytoplasm
Subacute and chronic neuronal injury - Answers✔"Degeneration"
-Progressive
-i.e. ALS & Alzheimers
Cell loss (apoptotic death)
Associated reactive glial changes**(best indicator)
Where are axonal reactions best seen? - Answers✔Anterior horn cells of the spinal cord when
motor axons are cut or damaged
What morphologies are seen in the following?
-Herpetic Infection
-Rabies
-Alzheimers Disease
-Parkinsons Disease
-Cruetzfeldt-Jakob Disease - Answers✔-Herpetic Infection = Cowdry Body
-Rabies = Negri Body
2
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-Alzheimers Disease = Neurofibrillary tangles
-Parkinsons Disease = Lewy Bodies
-Cruetzfeldt-Jakob Disease = Abnormal vacuolization of perikaryon and neuronal cell processes
in the neutrophil
What is the most important morphologic indicator of CNS injury? - Answers✔Gliosis
Vasogenic Edema vs. Cytotoxic Edema - Answers✔Vasogenic*** - increased EC fluid causes
by blood brain distruption and increased vascular permeabillity --> shift from intravascular
compartment to Intracellular spaces
Cytotoxic Edema** - Increase in intracellular secondary to neuronal, glial, or endothelial cell
membrane damage (ISCHEMIA)**
2 Causes of intracranial herniation - Answers✔-Build up of CSF
-ANY increase in Intracranial pressure (any aetiology)
4 Areas of intracranial herniation - Answers✔1) Falx
2) Tentorial
3) Foramen Magnum --> Once brainstem has been herniated basically end of life
4) Calvarium
Neural Tube defect - Answers✔Failure of fusion of lateral folds of neural tube or rupture of
previously closed neural tube
Cause: Maternal Folic acid deficiency
Maternal Findings:
-Increased AFP in mothers serum
-Increased AFP in amniotic fluid in anencephaly, meningocele
Is there an increase in AFP with spina bifida occulta? - Answers✔NO!
only when we have open tube defects
Neural tube defect prevention - Answers✔-Maternal supplementation or food fortication with
folic acid
3
PA3306 Mod 10 Neuropathology Exam Study
Guide.
Neurologic Symptoms - Answers✔Headache
Abnormal Reflexes
Neck stiffness
Headache: Intracranial causes vs Extracranial causes - Answers✔Intracranial:
-Raised IC pressure
-Constriction and dilation of IC vessels (migraine)
-Irritation or inflammation of meninges
Extra-cranial:
-Referral
-GCT arteritis
Exaggerated vs. Impaired reflexes - Answers✔Exaggerated
-UMN CST lesion
Impaired:
-LMN CST lesion
-Compression of motor nerve roots
-Peripheral neuropathy
Reactions of Neurons to injury - Answers✔Acute - anaerobic of glucose depleted
Chronic - accumulation of abnormal proteins (aggregates) --> degenerative disorders of the brain
1
, ©FYNDLAY.
High sensitivity to oxygen starvation --> Inability to generate AP
Neuronal life span
Accumulation of misfolded proteins (proteinopathies)
Acute Neuronal Injury - Answers✔Red Neurons* (earliest marker of neuronal cell death- can see
by 12-24 hours post insult)
Morphologic features:
-Shrinkage cell body
-Pyknosis nucleus
-disappearance of nucleosus
-loss of nissl substance
-intense eosinophilia of the cytoplasm
Subacute and chronic neuronal injury - Answers✔"Degeneration"
-Progressive
-i.e. ALS & Alzheimers
Cell loss (apoptotic death)
Associated reactive glial changes**(best indicator)
Where are axonal reactions best seen? - Answers✔Anterior horn cells of the spinal cord when
motor axons are cut or damaged
What morphologies are seen in the following?
-Herpetic Infection
-Rabies
-Alzheimers Disease
-Parkinsons Disease
-Cruetzfeldt-Jakob Disease - Answers✔-Herpetic Infection = Cowdry Body
-Rabies = Negri Body
2
, ©FYNDLAY.
-Alzheimers Disease = Neurofibrillary tangles
-Parkinsons Disease = Lewy Bodies
-Cruetzfeldt-Jakob Disease = Abnormal vacuolization of perikaryon and neuronal cell processes
in the neutrophil
What is the most important morphologic indicator of CNS injury? - Answers✔Gliosis
Vasogenic Edema vs. Cytotoxic Edema - Answers✔Vasogenic*** - increased EC fluid causes
by blood brain distruption and increased vascular permeabillity --> shift from intravascular
compartment to Intracellular spaces
Cytotoxic Edema** - Increase in intracellular secondary to neuronal, glial, or endothelial cell
membrane damage (ISCHEMIA)**
2 Causes of intracranial herniation - Answers✔-Build up of CSF
-ANY increase in Intracranial pressure (any aetiology)
4 Areas of intracranial herniation - Answers✔1) Falx
2) Tentorial
3) Foramen Magnum --> Once brainstem has been herniated basically end of life
4) Calvarium
Neural Tube defect - Answers✔Failure of fusion of lateral folds of neural tube or rupture of
previously closed neural tube
Cause: Maternal Folic acid deficiency
Maternal Findings:
-Increased AFP in mothers serum
-Increased AFP in amniotic fluid in anencephaly, meningocele
Is there an increase in AFP with spina bifida occulta? - Answers✔NO!
only when we have open tube defects
Neural tube defect prevention - Answers✔-Maternal supplementation or food fortication with
folic acid
3
