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The Central Nervous System
Pathology of the Central Nervous System
Cerebrovascular Diseases
Cerebrovascular Diseases ,[object Object],[object Object]
Cerebrovascular Diseases ,[object Object],[object Object],[object Object],[object Object],[object Object]
Cerebrovascular Diseases ,[object Object],[object Object],[object Object]
Cerebrovascular Diseases ,[object Object]
Hypoxia, Ischemia, and Infarction
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object],Morphology
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object],Morphology
Cerebral infarction.  A, At low magnification, it is possible to see the demarcated areas of an acute infarction.  In the underlying white matter, the areas of infarction are well shown by the myelin stain.  B, Acute ischemic injury causes diffuse eosinophilia of neurons, which are beginning to shrink.  C, infiltration of a cerebral infarct by neutrophils begins at the edges of the lesion where vascular supply has remained intact.  D, After about 10 days, an area of infarction is characterized by the presence of macrophages and surrounding reactive gliosis.  E, Remote small intracortical infarcts are seen as areas of tissue loss with a small amount of residual gliosis.
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],Morphology
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],[object Object],[object Object]
A, Sections of the brain showing a large, discolored, focally hemorrhagic region in the left middle cerebral artery distribution (hemorrhagic, or red, infarction)
C, A bland infarct with punctate hemorrhages, consistent with ischemia-reperfusion injury, is present in the temporal lobe.
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],Morphology
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object],Morphology
Hypoxia, Ischemia, and Infarction ,[object Object],[object Object],[object Object]
Intracranial Hemorrhage
Intracranial Hemorrhage ,[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object]
Common sites of saccular (berry) aneurysms in the circle of Willis
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],Morphology
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],Morphology
Intracranial Hemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hypertensive Cerebrovascular Disease
Hypertensive Cerebrovascular Disease ,[object Object],[object Object]
Hypertensive Cerebrovascular Disease ,[object Object],[object Object],[object Object],[object Object]
Lacunar infarcts in the caudate and putamen.
Hypertensive Cerebrovascular Disease ,[object Object],[object Object],[object Object]
Hypertensive Cerebrovascular Disease ,[object Object],[object Object],[object Object],[object Object]
Hypertensive Cerebrovascular Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Demyelinating Diseases
Demyelinating Diseases ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis
Multiple Sclerosis ,[object Object],[object Object],[object Object],[object Object]
Multiple Sclerosis ,[object Object],[object Object],[object Object]
Multiple Sclerosis ,[object Object],[object Object],[object Object]
Multiple Sclerosis ,[object Object],[object Object],Morphology
Multiple sclerosis.  Section of fresh brain showing brown plaque around occipital horn of the lateral ventricle.
Multiple Sclerosis ,[object Object],Morphology
Multiple Sclerosis ,[object Object],[object Object],Morphology
Multiple Sclerosis ,[object Object],Morphology
Multiple sclerosis. A, Unstained regions of demyelination (MS plaques) around the fourth ventricle (Luxol fast blue PAS stain for myelin).  B, Myelin-stained section shows the sharp edge of a demyelinated plaque and perivascular lymphocytic cuffs.  C, The same lesion stained for axons shows relative preservation.
Multiple Sclerosis ,[object Object],Morphology
Multiple Sclerosis ,[object Object],Morphology
Multiple Sclerosis ,[object Object],Morphology
Multiple Sclerosis ,[object Object],[object Object]
Multiple Sclerosis ,[object Object],[object Object],[object Object]
Multiple Sclerosis ,[object Object],[object Object],[object Object]
Multiple Sclerosis Variants
Multiple Sclerosis Variants ,[object Object],[object Object],[object Object]
Multiple Sclerosis Variants ,[object Object]
Acute Disseminated Encephalomyelitis and Acute Necrotizing Hemorrhagic Encephalomyelitis
Acute Disseminated Encephalomyelitis and Acute Necrotizing Hemorrhagic Encephalomyelitis ,[object Object],[object Object]
Acute Disseminated Encephalomyelitis and Acute Necrotizing Hemorrhagic Encephalomyelitis ,[object Object],[object Object],[object Object],[object Object]
Other Diseases With Demyelination
Other Diseases With Demyelination ,[object Object],[object Object]
Other Diseases With Demyelination ,[object Object],[object Object],[object Object]
Other Diseases With Demyelination ,[object Object]
Degenerative Diseases
Degenerative Diseases ,[object Object],[object Object],[object Object]
Degenerative Diseases ,[object Object]
Degenerative Diseases ,[object Object],[object Object],[object Object],[object Object]
Degenerative Diseases Affecting the Cerebral Cortex
Degenerative Diseases Affecting the Cerebral Cortex ,[object Object]
Alzheimer Disease
Alzheimer Disease ,[object Object],[object Object],[object Object]
Alzheimer Disease ,[object Object],[object Object],Morphology
Alzheimer disease with cortical atrophy most evident on the right, where meninges have been removed.
Alzheimer Disease ,[object Object],Morphology
Alzheimer disease.  A, Neuritic plaque with a rim of dystrophic neurites surrounding an amyloid core.
Alzheimer Disease ,[object Object],[object Object],[object Object],Morphology
Alzheimer Disease ,[object Object],[object Object],[object Object],Morphology
Alzheimer Disease.  B, Congo red stain of the cerebral cortex showing amyloid deposition in the blood vessels and the amyloid core of the neuritic plaque (arrow)
Alzheimer Disease.  C, Neurofibrillary tangles (arrowheads) are present within the neurons.
Alzheimer Disease ,[object Object],[object Object],[object Object],Morphology
Alzheimer Disease ,[object Object],[object Object],[object Object],Morphology
Alzheimer Disease ,[object Object],[object Object],[object Object],[object Object]
Alzheimer Disease ,[object Object],[object Object],[object Object],[object Object]
Alzheimer Disease ,[object Object],[object Object]
Alzheimer Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias
Frontotemporal Dementias ,[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],Morphology
Frontotemporal Dementias ,[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object],Morphology
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object],Morphology
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],Morphology
Frontotemporal Dementias ,[object Object],[object Object],[object Object],Morphology
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object],[object Object],[object Object]
Frontotemporal Dementias ,[object Object],[object Object]
Degenerative Diseases of Basal Ganglia and Brainstem
Degenerative Diseases of Basal Ganglia and Brainstem ,[object Object],[object Object],[object Object]
Parkinsonism
Parkinsonism ,[object Object],[object Object],[object Object]
Parkinsonism ,[object Object],[object Object],[object Object],[object Object]
Parkinsonism ,[object Object],[object Object],[object Object]
Parkinson Disease
Parkinson Disease ,[object Object],[object Object],[object Object],[object Object]
Parkinson Disease ,[object Object],[object Object]
Parkinson Disease ,[object Object],[object Object],[object Object],[object Object]
Parkinson Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multiple System Atrophy
Multiple System Atrophy ,[object Object],[object Object],[object Object],[object Object]
Multiple System Atrophy ,[object Object],[object Object],[object Object],Morphology
Multiple System Atrophy ,[object Object],[object Object],[object Object],[object Object]
Huntington Disease
Huntington Disease ,[object Object],[object Object],[object Object],[object Object]
Huntington Disease ,[object Object],[object Object],[object Object],[object Object],Morphology
Huntington disease (HD).  Normal hemisphere on the left compared with the hemisphere with HD on the right showing atrophy of the striatum and ventricular dilation.
Huntington Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Huntington Disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spinocerebellar Degenerations
Spinocerebellar Degenerations ,[object Object],[object Object],[object Object]
Spinocerebellar Ataxias
Spinocerebellar Ataxias ,[object Object],[object Object]
Spinocerebellar Ataxias ,[object Object],[object Object],[object Object],[object Object],[object Object]
Spinocerebellar Ataxias ,[object Object],[object Object],[object Object],[object Object],[object Object]
Spinocerebellar Ataxias ,[object Object],[object Object],[object Object]
Spinocerebellar Ataxias ,[object Object],[object Object],[object Object]
Spinocerebellar Ataxias ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Degenerative Diseases Affecting Motor Neurons
Degenerative Diseases Affecting Motor Neurons ,[object Object],[object Object],[object Object],[object Object]
Degenerative Diseases Affecting Motor Neurons ,[object Object],[object Object],[object Object],[object Object]
Amyotrophic Lateral Sclerosis (Motor Neuron Disease)
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) ,[object Object],[object Object],[object Object]
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) ,[object Object],[object Object]
Amyotrophic lateral sclerosis.  Spinal cord showing loss of myelinated fibers (lack of stain) in corticospinal tracts.  The anterior roots are smaller than the posterior roots.
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) ,[object Object],[object Object],[object Object]
Amyotrophic Lateral Sclerosis (Motor Neuron Disease) ,[object Object],[object Object],[object Object]
Bulbospinal Atrophy (Kennedy Syndrome)
Bulbospinal Atrophy (Kennedy Syndrome) ,[object Object],[object Object]
Spinal Muscular Atrophy
Spinal Muscular Atrophy ,[object Object],[object Object]
Genetic Metabolic Diseases
Genetic Metabolic Diseases ,[object Object],[object Object]
Genetic Metabolic Diseases ,[object Object],[object Object],[object Object],[object Object]
Genetic Metabolic Diseases ,[object Object],[object Object]
Leukodystrophies
Krabbe Disease
Krabbe Disease ,[object Object],[object Object],[object Object],[object Object]
Krabbe Disease ,[object Object],[object Object],[object Object],[object Object],[object Object]
Metachromatic Leukodystrophy
Metachromatic Leukodystrophy ,[object Object],[object Object],[object Object]
Metachromatic Leukodystrophy ,[object Object],[object Object],[object Object]
Metachromatic Leukodystrophy ,[object Object],[object Object],[object Object],[object Object],[object Object]
Metachromatic leukodystrphy.  Demyelination is extensive.  The subcortical fibers in the cerebral hemisphere are spared (Luxol fast blue PAS stain for myelin)
Adrenoleukodystrophy
Adrenoleukodystrophy ,[object Object],[object Object],[object Object],[object Object]
Pelizaeus-Merzbacher Disease
Pelizaeus-Merzbacher Disease ,[object Object],[object Object],[object Object]
Canavan Disease
Canavan Disease ,[object Object]
Mitochondrial Encephalomyopathies
Mitochondrial Encephalomyopathies ,[object Object]
Leigh Syndrome (Subacute Necrotizing Encephalopathy)
Leigh Syndrome (Subacute Necrotizing Encephalopathy) ,[object Object],[object Object],[object Object]
Leigh Syndrome (Subacute Necrotizing Encephalopathy) ,[object Object]
Other Mitochondrial Encephalomyopathies
Other Mitochondrial Encephalomyopathies ,[object Object],[object Object],[object Object]
Other Mitochondrial Encephalomyopathies ,[object Object],[object Object]
Toxic and Acquired Metabolic Diseases
Vitamin Deficiencies
Thiamine (Vitamin B 1 ) Deficiency
Thiamine (Vitamin B 1 ) Deficiency ,[object Object],[object Object],[object Object]
Thiamine (Vitamin B 1 ) Deficiency ,[object Object],Morphology
Vitamin B 12  Deficiency
Vitamin B 12  Deficiency ,[object Object],[object Object],[object Object]
Neurologic Sequelae of Metabolic Disturbances
Hypoglycemia
Hypoglycemia ,[object Object],[object Object],[object Object]
Hypoglycemia ,[object Object],[object Object]
Hyperglycemia
Hyperglycemia ,[object Object],[object Object],[object Object]
Hepatic Encephalopathy
Hepatic Encephalopathy ,[object Object],[object Object]
Toxic Disorders
Carbon Monoxide
Carbon Monoxide ,[object Object],[object Object],[object Object]
Methanol
Methanol ,[object Object],[object Object]
Ethanol
Ethanol ,[object Object],[object Object],[object Object],[object Object],[object Object]
Alcoholic cerebellar degeneration.  The anterior portion of the vermis (upper portion of figure) is atrophic with widened spaces between the folia.
Radiation
Radiation ,[object Object],[object Object],[object Object],[object Object]
Combined Methotrexate and Radiation-Induced Injury
Combined Methotrexate and Radiation-Induced Injury ,[object Object],[object Object],[object Object]
Combined Methotrexate and Radiation-Induced Injury ,[object Object],[object Object],[object Object]
Tumors
Tumors ,[object Object],[object Object],[object Object]
Tumors ,[object Object],[object Object]
Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Tumors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas
Gliomas ,[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],Morphology
Well-differentiated astrocytoma.  A, the right frontal tumor has expanded gyri, which led to flattening (arrows).
Gliomas ,[object Object],[object Object],[object Object],[object Object],Morphology
B, Glioblastoma multiforme appearing as a necrotic, hemorrhagic, infiltrating mass.
Gliomas ,[object Object],[object Object],[object Object],Morphology
Gliomas ,[object Object],[object Object],[object Object],Morphology
Gliomas ,[object Object],[object Object],[object Object],Morphology
Glioblastoma.  Foci of necrosis with pseudopalisading of malignant nuclei.  Also, glomeruloid body.
Gliomas ,[object Object],[object Object],[object Object],Morphology
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Pilocytic astrocytoma in the cerebellum with a nodule of tumor in a cyst.
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Ependymoma.  A, Tumor growing into the fourth ventricle, distorting, compressing, and infiltrating surrounding structures.
Gliomas ,[object Object],[object Object],[object Object],Morphology
Ependymoma. B, Microscopic apearance of ependymoma.
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Gliomas ,[object Object],[object Object],[object Object],[object Object]
Neuronal Tumors
Neuronal Tumors ,[object Object],[object Object],[object Object]
Neuronal Tumors ,[object Object],[object Object]
Neuronal Tumors ,[object Object],[object Object],[object Object]
Poorly Differentiated Neoplasms
Poorly Differentiated Neoplasms ,[object Object],[object Object]
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object],[object Object],Morphology
Medulloblastoma.  B, Sagittal section of brain showing medulloblastoma destroying the superior midline cerebellum.
Medulloblastoma.  C, Microscopic appearance of medulloblastoma.
Poorly Differentiated Neoplasms ,[object Object],[object Object],Morphology
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object]
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object]
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object]
Poorly Differentiated Neoplasms ,[object Object],[object Object],[object Object]
Other Parenchymal Tumors
Other Parenchymal Tumors ,[object Object],[object Object],[object Object],[object Object]
Other Parenchymal Tumors ,[object Object],[object Object],[object Object],[object Object]
Other Parenchymal Tumors ,[object Object],[object Object],[object Object]
Other Parenchymal Tumors ,[object Object],[object Object],[object Object]
Meningiomas
Meningiomas ,[object Object]
A, parasagittal multilobular meningioma attached to the dura with compression of underlying brain.  B, Meningioma with a whorled pattern of cell growth and psammoma bodies.
Meningiomas ,[object Object],[object Object]
Meningiomas ,[object Object],[object Object],[object Object]
Meningiomas ,[object Object],[object Object]
Meningiomas ,[object Object],[object Object],[object Object]
Metastatic Tumors
Metastatic Tumors ,[object Object],[object Object]
Paraneoplastic Syndromes
Paraneoplastic Syndromes ,[object Object],[object Object]
Paraneoplastic Syndromes ,[object Object],[object Object],[object Object],[object Object]
Peripheral Nerve Sheath Tumors
Peripheral Nerve Sheath Tumors ,[object Object]
Peripheral Nerve Sheath Tumors ,[object Object],[object Object]
Peripheral Nerve Sheath Tumors ,[object Object],[object Object],[object Object],[object Object]
Schwannoma.  A, Bilateral eighth nerve schwannomas.
Schwannoma.  B, Tumor showing cellular areas, including Verocay bodies (far right), as well as looser, myxoid regions.
Peripheral Nerve Sheath Tumors ,[object Object],[object Object],[object Object]
Peripheral Nerve Sheath Tumors ,[object Object],[object Object],[object Object]
Peripheral Nerve Sheath Tumors ,[object Object],[object Object],[object Object],[object Object]
Credits Books: PBD, 7th Ed. Photos: PBD Interactive Case Study Companion Elsevier Internet:  		 http://www.med.uottawa.ca/patho/neuro/introneuropathology.h tm 		 http://www.radnet.ucla.edu/sections/DINR/Part%2013/Part13A2.h tm

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