Disorders of CNS

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Disorders of CNS
Dr. Venkatesh M. Shashidhar Associate Professor
of Pathology Fiji School of Medicine
A Commitment to Excellence
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CNS

• 2 body Wt but 20 Oxygen.
• Hypoxia First to get affected.
• Fluid tissue! Floats in CSF.
• Very delicate, less support, BV
• Limited space - Hard bony shell.
• No regeneration Permanent cells.

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Herniation - Trauma
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Herniation - Trauma
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Cerebral edema
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Cerebrovascular disease (Stroke)
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Introduction

• Third leading cause of death.
• Disease of brain due to lack of blood.
• Atherosclerosis is the most common cause.
• Clinically Stroke or CVS Acute onset of focal
  neurologic deficit.
• Ischemia Infarction Liquifactive necrosis.
  Healing leads to cystic spaces.

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Types

• Slow Progress / Pale infarct
• Slow blockage, Liquifaction necrosis, White/Pale
  infarct.
• Rapid Progress / Red infarct
• Sudden blockage, necrotic, hemorrhage.
• Rupture of vessel -

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Edema, loss of demarcation
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Cerebral Infarct - 1 Week
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Cerebral Infarct - 2 Weeks
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Cerebral Infarction - Late
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Subarachnoid Hemorrhage
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Intraventricular Hemorrhage
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Infarct with Punctate hemorrhage
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Meningitis
Dr. Venaktesh M. Shashidhar Senior Lecturer
Pathology Fiji School of Medicine
A Commitment to Excellence
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Meningitis

• Inflammation of Meninges - Leptomeningitis
• Meningoencephalitis Brain meninges
• Types
• Infective Septic Aseptic (B, V, F TB)
• Chemical Drugs
• Carcinomatous - metastasis
• Headache Neck stiffness. Neurological deficits
• Complications Encephalitis, Infarction, Abscess,
  Hydrocephalus empyema.

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Septic Meningitis
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Septic Meningitis
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Septic Meningitis
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Septic Meningitis-Microscopy
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CSF-Examination
N Septic Viral
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Septic Meningitis-Spinal fluid
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Brain Abscess
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Brain Abscess CT Scan
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Hydrocephalus
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Autopsy

• Marked inflammtory infiltrate in meninges
• Superficial Cerebral edema (cortex)

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Meningitis - Cryptococci

• Round capsulated fungal organisms
• Lymphocytic infiltrate around

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Summary

• Inflammation of Meninges.
• Head ache, Neck stiff ness.
• Septic Aseptic types CSF diagnosis
• Bacterial, viral, other.
• Complications Hydrocephalus.

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CNS Tumors
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Characteristics

• Limited space, more symptoms.
• Vital structures, location determines clinical
  features than the tumor itself.
• Do not spread beyond Skull.
• Neurons do not produce tumors.
• Metastatic T. Glioma Meningioma

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Clinical features

• Local Compression Infiltration
• Nerve tract deficits, Paralysis, seizures etc.
• Raised Intracranial Pressure.
• Headache, vomiting, slow pulse, papilloedema.

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Meningioma

• Arise from meninges covering of brain.
• capsulated, slow growing (Benign)
• Effect by pressure.
• No infiltration or metastasis (Benign).
• Surgery.

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Meningioma
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Meningioma
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Glioma

• Neoplasms of supporting glial cells.
• Astrocytoma - Commonest in adults
• Diffuse, no border,
• Varying grades, slow to very rapid.
• Difficult to treat.

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Glioma Cerebrum
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Glioma
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Glioma
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Cortical atrophy Alzheimers
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Anencephaly
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Hydrocephaly
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Summary

• Very delicate sensitive to hypoxia.
• Limited space, vital permanent structures
• Vascular, infection, Neoplastic degeneration.
• Stroke, Meningitis (septic/Aseptic)
• Neoplasms Meningioma, glioma.
• Parkinsons disease Alzheimers disease.