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 →

Fetal Gyral Development

During the first half of gestation, the human fetal brain has a smooth surface.  At about 20 weeks gestation, the brain begins to form the bumps (gyri) and grooves (sulci) that are typical of the adult brain, averaging about 1 sulcus per week of gestation after 20 weeks.  The brain of this 25 week gestation... 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 →

Periventricular Leukomalacia (PVL)

Periventricular Leukomalacia (PVL) is a type of brain damage that affects fetuses and premature babies. At this stage of brain  development, the white matter surrounding the ventricles is particularly vulnerable to hypoxic (lack of oxygen) or ischemic (lack of blood flow) injury for a variety of reasons, including high metabolic demand in a location that... 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 →

Cortical Atrophy in an Elderly Person (90 years old)

A normal adult loses about 0.2% of brain volume every year after middle age.  Compared to young and middle-aged adults, the brains of the elderly have comparatively widened sulci, narrowed gyri, a thin cortical ribbon, and enlarged ventricles due to progressive brain volume loss, which, clinically, may contribute slower processing speed for cognitive tasks and other changes.  Microglia-mediated synaptic pruning and other etiologies for decreasing cortical volume in the... Continue Reading →

Ice Cream and Imaging: Typical Appearance of Vestibular Schwannoma

Cranial nerve schwannomas most commonly arise from Schwann cells that myelinate the distal aspect of the vestibular division of the 8th cranial nerve. Vestibular schwannomas, sometimes referred to by the double misnomer "acoustic neuroma" (it is a double misnomer because they are not neuromas and they do not usually involve the acoustic division of cranial... Continue Reading →

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