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==Anatomy== | ==Anatomy== | ||
===General=== | |||
* Central nervous system (CNS): Brain, spinal cord. | |||
*Cortex: | |||
**Cerebral lobes: Frontal, parietal, temporal, occipital, insula. | |||
*Diencephalon: Thalamus, hypothalamus. | |||
*Mesencephalon: Colliculi (superior, inferior). | |||
*Metencephalon: Pons, cerebellum. | |||
*Myelencephalon: Medulla. | |||
*Ventricular system: | |||
**Lateral ventricles, interventricular foramen, third ventricle, cerebral aquaeduct, fourth ventricle, subrachnoid space. | |||
*Meninges: | |||
**Outer Covering, CSF circulation, buoyancy of brain. | |||
**Falx cerebri (between hemispheres), Tentorium cerebelli (separates cerebellum). | |||
<gallery> | |||
File:Brain_autopsy_top_view.jpg | Brain: Top view | |||
File:Brain_autopsy_bottom_view.jpg | Brain: Bottom view | |||
File:Brain_autopsy_lateral_view.jpg | Brain: Lateral view | |||
File:Blausen 0104 Brain x-secs SectionalPlanes.png | Orientation planes (WC/blausen staff) | |||
File:1202_White_and_Gray_Matter.jpg | Gray and white matter | |||
</gallery> | |||
===Important=== | ===Important=== | ||
*Basal ganglia | |||
**Includes: Nucleus caudatus, putamen, pallidum, subthalamus, substantia nigra | |||
**Part of the forebrain. | |||
**Caudate nucleus + putamen = striatum. | |||
**Pallidum + putamen = lenticular nucleus. | |||
<gallery> | |||
File:Blausen_0076_BasalGanglia.png | Schematic overview (WC/blausen staff) | |||
File:Basal_ganglia_1.jpg | Section with descriptions (WC/SMH) | |||
</gallery> | |||
*Uncus (as in ''uncal herniation''). | *Uncus (as in ''uncal herniation''). | ||
<gallery> | |||
File:Uncus_animation_small.gif | Position of the uncus | |||
File:Slide2cuc.JPG | Uncus bottom view (WC/Anatomist90) | |||
</gallery> | |||
*Cerebellar tonsils (as in ''tonsillar herniation''). | *Cerebellar tonsils (as in ''tonsillar herniation''). | ||
*Hippocampus (as in ''hippocampal sclerosis''). | |||
<gallery> | |||
File:Hippocampus.png | Location of the hippocampus in the brain (WC/Washington irving) | |||
File:Human temporal lobe areas.png | Hippocampus is marked blue on this coronar section (PLoS/Talbot et al.) | |||
File:Hippocampus macroscopy.jpg| Macroscopic specimen after formalin fixation showing hippocampus in coronar section (WC) | |||
</gallery> | |||
*Longitudinal fissure - divides cerebrum into hemispheres. | *Longitudinal fissure - divides cerebrum into hemispheres. | ||
<gallery> | |||
File:Longitudinal fissure of cerebrum.gif| Animation showing position of longitudinal fissure in the brain (WC) | |||
File:Human brain longitudinal fissure.png | Superior view on longitudinal fissure (WC) | |||
</gallery> | |||
*Lateral sulcus (Sylvian fissure, lateral fissure) - separates temporal lobe from frontal lobe & parietal lobe. | *Lateral sulcus (Sylvian fissure, lateral fissure) - separates temporal lobe from frontal lobe & parietal lobe. | ||
<gallery> | |||
File:Lateral sulcus.gif | Animation showing position of lateral sulcus in the brain (WC) | |||
File:Human brain lateral view description.JPG | Fixated brain, lateral view. The sulcus centralis is marked with 5 (WC) | |||
</gallery> | |||
*Central sulcus - separate ''parietal lobe'' from ''frontal lobe''. | *Central sulcus - separate ''parietal lobe'' from ''frontal lobe''. | ||
<gallery> | |||
File:Central sulcus animation.gif|Animation displaying position of central sulcus (WC) | |||
File:Central sulcus superior view.png| Superior view on central sulcus (WC) | |||
File:Human brain lateral view description.JPG | Fixated brain, lateral view. The sulcus centralis is marked with 6 (WC) | |||
</gallery> | |||
*Brain stem = medulla oblongata, pons, mesencephalon (midbrain).<ref>{{Ref Martini6|466}}</ref> | *Brain stem = medulla oblongata, pons, mesencephalon (midbrain).<ref>{{Ref Martini6|466}}</ref> | ||
<gallery> | |||
File:1311 Brain Stem.jpg | The three distinct parts of the brainstem are colored in this sagital section of a human brain (WC) | |||
File:Slide2RAFA.JPG | Anterior view on a formalin fixated brainstem (WC). | |||
File:Human brain frontal (coronal) section.JPG | Coronal section through brainstem and hemispheres (WC) | |||
</gallery> | |||
===Less important=== | ===Less important=== | ||
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**Branch off ''vertebral arteries''. | **Branch off ''vertebral arteries''. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Circle_of_Willis_en.svg | Circle of Willis. (WC) | |||
</gallery> | |||
www: | |||
*[http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS334A.html Interactive schematic (utah.edu)]. | *[http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS334A.html Interactive schematic (utah.edu)]. | ||
| Line 98: | Line 164: | ||
Intradural: | Intradural: | ||
* [[Meningioma]]. | * [[Meningioma]]. | ||
* | * [[Neurofibroma]]s. | ||
* Schwannoma. | * [[Schwannoma]]. | ||
* Arachnoid cyst. | * [[Arachnoid cyst]]. | ||
Extradural: | Extradural: | ||
* [[Chordoma]]. | * [[Chordoma]]. | ||
* [[Schwannoma]]. | * [[Schwannoma]]. | ||
* Sarcoma. | * [[Sarcoma]]. | ||
* Plasmacytoma. | * [[Plasmacytoma]]. | ||
* Primary bone | * Primary bone tumours - [[osteosarcoma]], osteochondroma, [[chondrosarcoma]]. | ||
* Mets (lung, breast, etc.). | * Mets (lung, breast, etc.). | ||
==Neuropathological dissection (autopsy)== | |||
Brain fixation after removal: Usually 14 days | |||
*Check brain for: | |||
** Lesions | |||
** edema (might be not visible but tissue is softer than normal) | |||
** hemorrhage | |||
** Discolorations | |||
** Asymmetry (midline shift) | |||
** herniation (subfalxial, uncal, tonsillar) | |||
** vascular abnormalities | |||
<gallery> | |||
File:MCA-Stroke-Brain-Human-2.JPG | Asymmetry (midline shift) indicating lesions (stroke, tumor) | |||
File:Brain_autopsy_hemorrhage_bottom_view.JPG | Brain hemorrhage | |||
File:Autopsy brain.jpg | Atrophy: widespread sulci, often seen in neurodegenerative diseases | |||
File:Alexander autopsy.jpg | Brown discolorations indicating demyelinisation | |||
</gallery> | |||
==Sampling - sections (autopsy)== | ==Sampling - sections (autopsy)== | ||
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Standard histologic sections: | Standard histologic sections: | ||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | {| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | ||
! '''Site''' | |||
! '''Routine'''<ref name=Ref_HospAuto164>{{Ref HospAuto|164}}}}</ref> | |||
! '''Head injury'''<ref name=Ref_HospAuto174>{{Ref HospAuto|176}}}}</ref> | |||
! '''[[Epilepsy]]'''<ref name=Ref_HospAuto179>{{Ref HospAuto|179}}}}</ref> | |||
! '''[[Dementia]]'''<ref name=Ref_HospAuto180>{{Ref HospAuto|180}}}}</ref> | |||
|- | |- | ||
| Frontal cortex | | Frontal cortex | ||