CNS Pathology - I
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Transcript of CNS Pathology - I
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CNS Pathology - I
Bleeding in theSkullRegion
Jaroslava DuškováInst. Pathol. ,1st Med. Faculty, Charles Univ. Prague
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Bleeding in the Skull Region extracranial
(kefalhaematoma externum, subperiostal, subaponeurotic)
intracranialextracerebral intracerebral
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v.cerebri magna Galeni
EDSD
SA IP
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Bleeding in the Skull Region – intracranial haemorrhages
extracerebralepiduralsubduralsubarachnoideal
intracerebralcapillaryvenousarterialcircumscribeddestructive
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Fetal & Neonatal Bleeding
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Germinal Zone (GZ) Bleeding
25% preterm neonates (decreasing recently)
GZ: periventricular, large calibre capillaries, highly vascularized esp. in the 3rd. trimestre
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Patogenesis of GZ Bleeding
Perinatal ev. intranatal hypoxia– disorder of cerebral perfusion autoregulation– ischemic endothelial capillary lesions in the GZ– myocardial energy reserves exhausted– perinatal circulation failure– cerebral hypoxia venous haemorrhage
Blood pressure increase– muscle activity of neonate– resuscitation– arteficial ventilation
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Closed Cerebral Trauma –traumatology classification
Type of injury Diffuse
– commotion– diffuse axonal injury
Focal– contusion
Compression– hematomas (epidural,
subdural, intracranial)– hygroma
Therapy Conserv.
Conserv.sometimesevacuation
SURGICAL
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Punch-Drunk Syndrome – (dementia pugilistica)
clinically obvious years after the last fight three stages:
– affective disorders, mild incoordination– dysphasia, apraxia, agnosia, apathy, blunting of
affects– global cognitive decline & parkinsonism
present in 20% of profess. boxers over 50 more likely to develop in boxers with long
careers SN degeneration, neuronal loss, Alzheimer
intracellular changes
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Brain Perfusion FailureEncephalomalacia
whiteredmixed
Causes ischemia venostasis
Postencephalomalatic pseudocyst (event.)
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Cerebral Arteries Atherosclerosis
Morphological features – encephalomalacia– encephalopathia angiosclerotica:
atrophia cerebri diffusa status cribrosus status lacunaris hydrocephalus ext. et int. e vacuo
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Cerebral Arteries Atherosclerosis
Clinical features – cerebral infarction (event. death)– pyramidal and extrapyramidal signs– atherosclerotic (multiinfarct)
demention (-100ml!)