CNS Pathology - I

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CNS Pathology - I

• Bleeding
• in the
• Skull
• Region

Jaroslava Dušková Inst. Pathol. ,1st Med.
Faculty, Charles Univ. Prague
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Bleeding in the Skull Region

• extracranial
• (kefalhaematoma externum, subperiostal,
  subaponeurotic)
• intracranial
• extracerebral
• intracerebral

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ED
SD
v.cerebri magna Galeni
SA
IP
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Bleeding in the Skull Region intracranial
haemorrhages

• extracerebral
• epidural
• subdural subarachnoideal

• intracerebral
• capillary
• venous
• arterial
• circumscribed
• destructive

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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.
• sometimes
• evacuation
• 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 Failure

• Encephalomalacia
• white
• red
• mixed
• 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!)