Brain Edema

Cerebral edema, or increased swelling in the brain, can occur as the result of numerous etiologies, such as infection, inflammation, metabolic derangement, or neoplastic processes.  Typically the brain has an undulating contour featuring crests or bumps called gyri, and troughs or grooves, called sulci.  The mass effect produced by cerebral edema results in pushing or... Continue Reading →

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Dandy-Walker Malformation

Dandy-Walker malformation, an uncommon brain abnormality that may be seen in isolation or in association with other congenital abnormalities of brain development, is characterized by an enlarged posterior fossa, agenesis or hypoplasia of the cerebellar vermis, and cystic dilatation of the fourth ventricle.  In this case of a term infant with multiple congenital abnormalities, the superior most aspect of the... Continue Reading →

Lacunar Infarction of Basal Ganglia

A lacunar infarct is a small infarction, or stroke, that is usually less than about 1 to 1.5 cm in size and typically occurs in deep cerebral structures (e.g. basal ganglia) of hypertensive or diabetic patients with small vessel disease of deep penetrating arteries (e.g. lenticulostriate arteries) . The gross impression of this brain, which belonged to... Continue Reading →

Brain Eating Amoeba

Naegleria fowleri, better known as "brain-eating amoeba", is a free-living amoeba that is a major cause of a rare brain infection called Primary Amebic Meningoencephalitis, which typically affects young people with a history of swimming in warm fresh water such as a lake or stream. After entering the nose and crawling up the olfactory nerves... Continue Reading →

Malignant Meningitis

The brain is surrounded by several layers of protective coverings collectively called meninges.  The semi-translucent innermost layers, called the leptomeninges, form a "shrink-wrap" around the brain that allows for easy flow of cerebrospinal fluid (CSF) along the outer surface of central nervous system structures. Unfortunately, it also allows for easy spread of neoplastic cells.  The image shows the inferior aspect... Continue Reading →

Myxopapillary Ependymoma: Radiology-Pathology Correlation

Myxopapillary ependymoma arises in the lumbar region of the spinal cord and typically produces symptoms associated with impingement of the spinal nerve roots of the cauda equina. It usually appears as an oval or sausage-shaped contrast-enhancing mass, like the one pictured in this MRI image (sagittal post-contrast T1 Fat-sat).  The myxopapillary ependymoma in the inset photograph represents a gross surgical... Continue Reading →

Secretory Meningioma: A unique Meningioma variant

The secretory subtype of meningioma (pictured here) is just one of many variants of meningioma, a usually histologically benign tumor that arises from the meninges (i.e. the outer coverings overlying the brain) and often contains concentrically-layered calcifications called psammoma bodies.  The secretory variant can be suspected on imaging by the exuberant edema often seen in the adjacent brain tissue.  Microscopically,... Continue Reading →

True Ependymal Rosettes in Ependymoma

The microscopic appearance of ependymomas is dominated by the presence of radially-arranged tumor cells forming rosettes (black arrows), which are named for their resemblance to the flower-like architecture of rose windows in gothic cathedrals.  The perivascular pseudorosette, characterized by tumor cells radially arranged around a central vessel, is more common by far, but it is not specific to... Continue Reading →

Severe Jaundice of the Brain

Not a trick of the eyes.  This brain with a pronounced green discoloration belonged to an adult with marked jaundice due to acute and severe liver disease. Jaundice occurs when the blood carries higher than normal levels of bilirubin, a substance that is usually processed by the liver into bile which is then eliminated via the stool and urine. Liver disease... Continue Reading →

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