Neuropathology

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Neuropathology

• Major Topics for Discussion
• Neuroanatomy congenital anomalies
• Trauma to the CNS
• Circulatory disorders affecting the CNS
• Infectious diseases affecting the CNS
• Demyelinating diseases
• Neurodegenerative diseases
• Tumors of the CNS

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Some neurons are pigmented (e.g., dopaminergic
neurons of the substantia nigra).
Neurons come in a varitety of sizes and shapes.
They are supported by various accessory (glial)
cells.
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Acute Neuron Cell Injury is Manifest as Hydropic
Swelling
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Viral Inclusion Body
Astrocytes Responding to Local Injury (Gliosis)
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White Matter is Filled with Myelin-Producing
Oligodendrocytes
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Spina Bifida

• Neural tube defect
• Folic acid protects

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Myelomeningocele

• Herniation of meninges and spinal nerves

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Acrania (Anencephaly)
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Hydrocephalus

• Excessive amount of CSF
• Ventricular enlargement
• Congenital or acquired

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Polygyri (Congenital Birth Defect)
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Pachygyri (Congenital Birth Defect)
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Epidural Hematoma

• Severance of middle meningeal artery by blunt
  force trauma

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Epidural Hematoma
Epidural hematomas are invariably progressive and
fatal in 24-48 hour, unless the blood is
evacuated.
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Brain StemCompression

• Fatal event
• Transtentorial herniation

Note herniation of cerebral tonsils
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Duret Hemorrhages

• Fatal complication of transtentorial herniation
• Brainstem hemorrhage and necrosis

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Subdural Hemorrhage

• Torn bridging veins caused by trauma

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Subdural Hematoma
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Brain Trauma - Contusion
Note Concussion is a different term - that
signifies loss of consciousness.
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Cerebral Contusions
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Recent Cerebral Contusions with Multiple Sites of
Brain Hemorrhage
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Penetrating Wound to Brain
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Knife Wound (Lethal Hemorrhage)
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Spinal Cord Injury
These injuries often lead to paraplegia or
quadriplegia.
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Circulatory Disorders

• Aneurysms
• Hemorrhage
• Ischemia
• Infarction

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Berry Aneurysm (Congenital Weakness of Artery)
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Pathogenesis of Berry Aneurysm
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HypertensiveAneurysm
The pathologic term for these hypertension-associa
ted brain lesions is Charcot-Bouchard Aneurysm
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Cerebral Hemorrhage
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Complications of Global Ischemia

• Zone of Watershed Infarct

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Watershed Infarct
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Distribution of Cerebral Infarcts
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CerebralInfarct

• Cerebral ischemia and infarction represent the
  major causes of stroke.

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Resorption and Cyst Formation
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Atherosclerosis

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Atherosclerotic aneurysm
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Fat Embolism

• Numerous petechia in the white matter
• Complication of trauma

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Sagital Sinus Thrombosis

• Complication of
• Sickle cell disease
• Dehydration
• Sepsis

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Hydrocephalus (dilation of ventricles) in a
patient with a brain tumor obstructing the
aqueduct of Sylvius
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Infections of the Brain
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Purulent Meningitis

• Infection of membranes covering surface of the
  brain (meninges)
• Caused by variety of microorganisms

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E. coli Meningitis
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Haemophilus influenzae Meningitis
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BrainAbscess

• Potentially fatal

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Distribution of Viral Lesions
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Herpes Encephalitis

• Hemorrhagic necrotizing inflammation

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Demyelinating Diseases

• Multiple Sclerosis

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Coronal Section of Brain from Patient with
Multiple Sclerosis - Luxol Fast Blue Stain for
Myelin
Plaques in white matter
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Neurodegenerative Diseases

• Parkinson Disease
• Huntington Disease
• Alzheimer Disease
• Spongiform Encephalopathy

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Neurodegenerative Diseases
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Loss of Neurons from Substantia Nigra in Patients
with Parkinson Disease
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Brain Atrophy in Patients with Alzheimer Disease
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Microscopic Lesions in Alzheimer Disease
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Amyloid Surrounding Vessels
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Neurofibrillary Tangles in Patients with
Alzheimer Disease
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Spongiform Degeneration in Prion Disease (Mad Cow)
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Primary Brain Neoplasms

• Meningioma
• Astocytoma
• Glioblastoma Multiforme

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Meningioma
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Bone Invasion of Aggressive Meningioma
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Astrocytoma
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Glioblastoma Multiforme
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Path Key Words

• Alzheimer disease
• Amyotrophic lateral sclerosis
• Astocytoma
• Astrocytes
• Bacterial meningitis
• Berry aneurysm
• Cerebral abscess. .
• Cerebral contusion
• Congenital hydrocephalus
• Ependymoma

• Glioblastoma multiforme
• Huntington disease
• Microglial cells
• Multiple sclerosis
• Oligodendroglial cells
• Parkinson disease
• Spongiform encephalopathies
• Viral encephalomyelitis
• Watershed infarct
• Wernicke syndrome