Difference between revisions of "Neuropathology"

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Neuropathology (view source)

Revision as of 04:07, 2 November 2010

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split-out anatomy + grossing
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(split-out anatomy + grossing)
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This article is an introduction to neuropathology.  There are separate articles for [[brain tumours]], the [[pituitary gland]] and [[muscle pathologies]].
This article is an introduction to neuropathology.  There are separate articles for [[brain tumours]], the [[pituitary gland]] and [[muscle pathologies]].


==Gross==
==Neuroanatomy==
===Important===
{{Main|Neuroanatomy}}
*Uncus (as in ''uncal herniation'').
This is a large topic. It covered in a separate article, that also covers grossing.
*Cerebellar tonsils (as in ''tonsillar herniation'').


*Longitudinal fissure - divides cerebrum into hemispheres.
==Grossing==
*Lateral sulcus (Sylvian fissure, lateral fissure) - separates temporal lobe from frontal lobe & parietal lobe.
This is covered in the ''[[neuroanatomy]]'' article.
*Central sulcus - separate ''parietal lobe'' from ''frontal lobe''.
*Brain stem = medulla oblongata, pons, mesencephalon (midbrain).<ref>{{Ref Martini6|466}}</ref>
 
===Less important===
*Glomeruli of Arnold.
**Over lies hippocampus.
*Calcarine cortex - occipital lobe
**Line of Gennari -- very thin white line in the grey matter.
**Image: [http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS227A.html Calcarine cortex (med.utah.edu)] as part of [http://www.gfmer.ch/selected_images_v2/detail_list.php?offset=15&cat1=3&cat2=13&cat3=0&cat4=2&stype=n CNS collection (gfmer.ch)].
*Nucleus accumbens (NAcc) - inferior-medial to where the internal capsule ends; anterior of optic chiasm.
**Images: [http://commons.wikimedia.org/wiki/File:Dopamine_and_serotonin_pathways.gif NAcc - sagittal (WC)], [http://commons.wikimedia.org/wiki/File:Nucleus_accumbens_MRI.PNG NAcc - frontal (WC)].
 
====Trivia====
*Claustrum - thin band of grey mater in the external capsule; function uncertain.<ref>URL: [http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg http://commons.wikimedia.org/wiki/File:Telencephalon-Horiconatal.jpg]. Accessed on: 22 September 2010.</ref>
 
===Vascular structures===
*Posterior cerebellar arteries.
**Inferior of ''posterior cerebral arteries''.
*Anterior inferior cerebellar arteries.
**Branch off ''basilar artery''.
*Posterior inferior cerebellar arteries - [[AKA]] ''PICA''.
**Branch off ''vertebral arteries''.
 
Images:
*[http://en.wikipedia.org/wiki/File:Circle_of_Willis_en.svg Circle of Willis (WP)] .
*[http://library.med.utah.edu/WebPath/HISTHTML/NEURANAT/CNS334A.html Interactive schematic (utah.edu)].
 
===Meninges===
Deep to superficial:
#Pia mater.
#Arachanoid membrane.
#*Subarachanoid space - contains blood vessels.
#Dura mater.
#*Tough outer covering.
 
====Lesion location classification====
Locations:<ref>URL: [http://www.nervous-system-diseases.com/spine-tumor.html http://www.nervous-system-diseases.com/spine-tumor.html]. Accessed on: 21 September 2010.</ref>
#Intra-axial = inside the (middle) of spinal cord/brain.
#*[[AKA]] intramedullary.
#Intradural = not intra-axial, but deep to the dural.
#*[[AKA]] extramedullary.
#Extradural = outside of dura.
 
*The above descriptors are often found in radiology reports.
 
====DDx based on location<ref>URL: [http://www.nervous-system-diseases.com/spine-tumor.html http://www.nervous-system-diseases.com/spine-tumor.html]. Accessed on: 21 September 2010.</ref>====
Intra-axial:<ref name=Ref_PSNP57>{{Ref PSNP|57}}</ref>
* Glioma (astrocytoma, oligodendroglioma, ependymoma).
* Non-glial tumours (hemangioblastoma, CNS lymphoma).
* Metastases.
* Non-tumour:
** Abscess.
** Infarct.
** Hematoma.
Intradural:
* Meningioma.
* Neurofibromas.
* Schwannoma.
* Arachnoid cyst.
Extradural:
* Chordoma.
* Schwannoma.
* Sarcoma.
* Plasmacytoma.
* Primary bone tumors - osteosarcoma, osteochondroma, chondrosarcoma.
* Mets (lung, breast, etc.).
 
===Sampling - sections (autopsy)===
:See ''[[autopsy]].
 
Standard histologic sections:
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto"
|
| '''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
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' - bilateral parasagittal [2]<!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' - middle frontal gyrus [1]<!-- '''Dementia''' -->
|-
| Cingulate gyrus
| N <!-- '''Routine''' -->
| N <!-- '''Head injury''' -->
| '''Y''' - parasagittal [1] <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Basal ganglia &<br>internal capsule
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' - bilateral with corpus callosum [2] <!-- '''Head injury''' -->
| '''Y''' - caudate, putamen, <br>globus palidus [1] <!-- '''Epilepsy''' -->
| '''Y''' - putamen, <br>globus palidus [1] <!-- '''Dementia''' -->
|-
| Basal ganglia, <br>internal capsule,<br>thalamus
| N <!-- '''Routine''' -->
| '''Y''' [2] <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| N <!-- '''Dementia''' -->
|-
| Temporal lobe
| N <!-- '''Routine''' -->
| N <!-- '''Head injury''' -->
| '''Y''' - superior & middle temporal gyri [2] <!-- '''Epilepsy''' -->
| '''Y''' - superior & middle temporal gyri [1] <!-- '''Dementia''' -->
|-
| Hippocampus
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' - bilateral [2]<!-- '''Head injury''' -->
| '''Y''' - also parahippocampal gyri [2]<!-- '''Epilepsy''' -->
| '''Y''' - also parahippocampal gyri [1]<!-- '''Dementia''' -->
|-
| Splenium of corpus callosum
| N <!-- '''Routine''' -->
| '''Y''' [1] <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| N <!-- '''Dementia''' -->
|-
| Parietal lobe
| N <!-- '''Routine''' -->
| '''Y''' - centrum semiovale (unilateral) [1]<!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' - inferior [1]<!-- '''Dementia''' -->
|-
| Occipital cortex
| '''Y''' [1] <!-- '''Routine''' -->
| N <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Midbrain
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' [1] <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Cerebellum (with<br>dentate gyrus)
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' - bilateral [2]<!-- '''Head injury''' -->
| '''Y''' - also vermis [2] <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Pons
| N <!-- '''Routine''' -->
| '''Y''' [1] <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Medulla
| '''Y''' [1] <!-- '''Routine''' -->
| '''Y''' [1] <!-- '''Head injury''' -->
| N <!-- '''Epilepsy''' -->
| '''Y''' [1] <!-- '''Dementia''' -->
|-
| Total sections
| [7] <!-- '''Routine''' -->
| [15] <!-- '''Head injury''' -->
| [8] <!-- '''Epilepsy''' -->
| [11] <!-- '''Dementia''' -->
|-
|}


==Normal histology==
==Normal histology==
Michael
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