Mass 1.Tumor 2.Blood clot 3.Abscess 4.Local edema S T
Transtentorial Herniation [involve Uncal gyral]
Transtentorial Herniation [Uncus]
Cerebral Herniation Complication of Intracranial Hypertension Tonsillar herniation Cerebellar tonsils herniate into the foramen magnum. Causes "coning" of the cerebellar tonsils Produces cardiorespiratory arrest Coma and Death 6
It can occur as an complication of Lumber Puncture
Complications of Tonsillar Herniation & Increased ICP Hemorrhagic lesion of the mid Brain and Pons : Secondary Brain stem or Duret hemorrhage Linear hemorrhage
Duret hemorrhage: pathogenesis Kinking of the penetrating median and paramedian pontine arteries that branch off the basilar artery.
Syringomyelia 22 Note the collapsed cystic cavity (syrinx) in the center of the cervical spinal cord
Brain contusion 23 The contrecoup injury involves the frontal and temporal lobes (left arrows) The coup lesion (site of impact) involves the cerebellum (right arrow).
Epidural and Subdural Hematoma 24
Red Neuron 25
Border zone infarct: Watershed infarct : Follows a Hypotensive episode. Lesion lies at the boundary between the anterior and middle cerebral artery territories.
Atherosclerotic (thrombotic) stroke 27
Amaurosis fugax 28
Embolic Stroke 29
Intracerebral Hemorrhage 30
Berry Aneurysms 31
Subarachnoid Hemorrhage 32
Lacunar Infarcts 33 The arrows show multiple small cystic spaces (liquefactive necrosis) that are most prominent in the basal ganglia.
Lacunar infarcts Cause : Chronic hypertension Site: The pons.
Microscopically, a neutrophilic exudate is seen involving the meninges
Spongiform encephalopathy of gray matter : brain lesion in CJD
Complications: sequel 1.Edema can lead to herniation and death. 2.Communicating hydrocephalous.
Meningeal Syphilis 1 of 2 Neurosyphilis is a tertiary stage of syphilis – only in 10% with untreated syphilis May involve spinal Meninges: produce thickening. Produce meningeal fibrosis and secondary Hydrocephalous.
Neutrophils in the abscess.
Abscess in the brain in a patient who had septicemia.
Atrophy There is marked atrophy seen superiorly and laterally.
The cortical atrophy leads to compensatory dilation of the cerebral ventricles [hydrocephalus ex vacuo ]