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CNS Pathology - I

CNS Pathology - I. Bleeding in the Skull Region. Jaroslava Dušková Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague. Bleeding in the Skull Region. extracranial (kefalhaematoma externum, subperiostal, subaponeurotic) intracranial extracerebral intracerebral. ED. SD.

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CNS Pathology - I

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

  2. Bleeding in the Skull Region • extracranial (kefalhaematoma externum, subperiostal, subaponeurotic) • intracranial extracerebral intracerebral

  3. ED SD v.cerebri magna Galeni SA IP

  4. extracerebral epidural subdural subarachnoideal intracerebral capillary venous arterial circumscribed destructive Bleeding in the Skull Region – intracranial haemorrhages

  5. Fetal & Neonatal Bleeding

  6. Germinal Zone (GZ) Bleeding 25% preterm neonates (decreasing recently) GZ: periventricular, large calibre capillaries, highly vascularized esp. in the 3rd. trimestre

  7. 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

  8. Type of injury Diffuse commotion diffuse axonal injury Focal contusion Compression hematomas (epidural, subdural, intracranial) hygroma Therapy Conserv. Conserv. sometimes evacuation SURGICAL Closed Cerebral Trauma–traumatology classification

  9. 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

  10. Brain Perfusion Failure Encephalomalacia white red mixed Causes ischemia venostasis Postencephalomalatic pseudocyst (event.)

  11. Cerebral Arteries Atherosclerosis Morphological features • encephalomalacia • encephalopathia angiosclerotica: • atrophia cerebri diffusa • status cribrosus • status lacunaris • hydrocephalus ext. et int. e vacuo

  12. Cerebral Arteries Atherosclerosis Clinical features • cerebral infarction (event. death) • pyramidal and extrapyramidal signs • atherosclerotic (multiinfarct) demention (-100ml!)

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