Spinal Ependymoma: Gross Specimen

Ependymomas are tumors that arise from specialized glia called ependymal cells, which line the central cerebral spinal fluid (CSF) containing spaces within the brain and spinal cord called the ventricles and central canal, respectively. When ependymomas occur in the spinal cord, their central location requires that the surgeon cut through the spinal cord in order... Continue Reading →

Hemangioblastoma: Gross and Microscopic Features

On gross examination, hemangioblastoma characteristically exhibits a yellow to yellow-orange color (similar to that of adipose tissue) due to the presence of lipid within the cytoplasm of neoplastic cells. On microscopic examination, the cells appear clear because the lipid that once filled the cytoplasm was washed out during tissue processing. Hemangioblastoma usually arises within the... Continue Reading →

Tripolar Atypical Mitosis in Glioblastoma

Cell division occurs in four major stages (prophase, metaphase, anaphase, and telophase) during which DNA duplicates itself and condenses, chromosomes centrally align and are pulled apart by two centrosomes on either side of the cell, and the cytoplasm separates to form two separate daughter cells. Cancer cells are able to enter into cell division by bypassing the usual complex ballet of cell... Continue Reading →

Vestibular Schwannomas

Intracranial schwannomas most commonly arise from the vestibular portion of the Vestibulocochlear nerve (cranial nerve VIII). The central/proximal aspect of the nerve is myelinated by oligodendroglial cells whereas the distal/peripheral aspect is myelinated by Schwann cells. These distally located Schwann cells give rise to vestibular schwannomas that originate in the distal aspect of the nerve, usually within the internal auditory canal where it... Continue Reading →

Resorption of Embolic Material in Arteriovenous Malformation (AVM)

Vascular brain lesions have increased risk of intracranial bleeding and, therefore, present a challenge to neurosurgeons attempting surgical resection.  Such tumors may first be embolized prior to surgical excision in order to reduce the risk of bleeding.  Onyx, an ethylene vinyl alcohol copolymer, is one of many embolic agents available to accomplish this task.  Onyx has... Continue Reading →

Hippocampal Atrophy

The hippocampus is critical to learning and memory.  Patients with hippocampal atrophy often have difficulty with declarative memory (i.e. remembering facts, names, events, etc.) and making new memories. Hippocampal atrophy can be seen a variety of disease processes, including epilepsy and neurodegenerative disease. Note how atrophy in this elderly patient, who had memory difficulties prior to... Continue Reading →

Cerebral Vascular Territories

The cerebral hemispheres are supplied with blood via three major arteries: the anterior, middle, and posterior cerebral arteries.  This coronal section through the frontal lobes shows hemorrhage involving the vascular territory of which of these three major cerebral arteries? Answer:  The cerebral hemispheres are supplied with blood via three major arteries: the anterior, middle, and posterior... Continue Reading →

Substantia Nigra decreased pigmentation in Parkinson Disease

The substantia nigra (literal translation: “black substance”) is a portion of the midbrain that contains pigmented dopamine-producing neurons.  Degeneration of these cells causes relative depigmentation the substantia nigra, representing a finding that is typical of Parkinson Disease, but may also be present in other neurodegenerative disorders such as Alzheimer Disease. Shown here is the basal... Continue Reading →

Dura Metastasis: Hepatocellular Carcinoma

The most common tumors found in the central nervous system and dura (i.e. the dense fibrous covering that envelops the brain) are those that have traveled from other body sites in a process called metastasis.  Depicted here is hepatocellular carcinoma (HCC), a cancer of liver cells, that has metastasized to the dura overlying the anterior pole of the right frontal lobe. Microscopically, the neoplastic liver... Continue Reading →

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