A forum dedicated to the expansion in neuropathology knowledge for students and practitioners alike.
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 →
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 →
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 →
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 →
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 →
For many years the only mechanism for observing gross pathologic features of CNS neoplasms was to examine brains extracted after death. However, advancements in imaging technology now allow providers to observe typical gross neuropathological findings in the brains of living patients. Some brain tumors have characteristic MRI findings, an example of which is a cyst... Continue Reading →
Schwannomas are peripheral nerve sheath tumors that arise from cells that myelinate peripheral nerve axons called Schwann cells. A classic histologic finding in schwannomas are Verocay bodies (arrows), which consist of short palisades of tumor cell nuclei separated by eosinophilic anucleate bands of tumor cell processes. Verocay bodies are often more prominent in schwannomas that arise in the setting of a... Continue Reading →
Oligodendrogliomas often show the classic “fried egg” appearance, in which each cell contains a small round monomorphic nucleus with a perinuclear region of clearing, as well as small delicate blood vessels, or “chicken-wire vasculature”. The fried egg morphology is an artifact of formalin fixation and will not be observed in frozen tissue sections. In addition,... Continue Reading →
Astrocytomas (i.e. glial tumors that diffusely infiltrate through brain tissue) are composed of neoplastic astrocytes that may occasionally exhibit certain morphologic differences when observed microscopically. Gemistocytic astrocytes are characterized by eccentric nuclei and plump pink cytoplasm that superficially resembles the belly of a pregnant woman when viewed from above. Neoplasms that are predominantly composed of... Continue Reading →
