Biopsy Interpretation of the Central Nervous System

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A companion website includes the fully searchable text, more than full-color images, and an interactive quiz bank that is ideal for board exam preparation. Inflammatory and Infectious Lesions.

Biopsy Interpretation of the Central Nervous System by Matthew J. Schniederjan (Hardback, 2017)

Astrocytic Neoplasms Ependymal Neoplasms. Neuronal and Mixed Glioneuronal Neoplasms. Sellar and Suprasellar Lesions.


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Meningeal Lesions. The first part of this article describes the neurological examination—the medical history, the physical examination of the patient, and the diagnostic tests and procedures that can be employed to provide a physician with information about a possible neurological disorder.

Next the principles used in localizing a disease within the nervous system are explained. The third part of this article provides an overview of pathological processes. Finally, an account is presented of the diseases of the nervous system, using a general classification based upon the primary or major site of the disease. The neurologist also notes symptoms such as pain , headache , loss of sensation , weakness, incoordination, wasting of certain muscle groups, and abnormal movements.

Biopsy Interpretation of the Central Nervous System

From full alertness a person can descend through drowsiness to stupor, a condition in which awareness is greatly reduced and the best motor response to stimulation is a groan or other vocal but not verbal reaction. Deeper levels of unconsciousness pass through light coma , in which strong stimulation produces only a clumsy motor response, to deep coma, in which there is only a reflex movement or no response at all.

Such depression of consciousness occurs when there is impairment of the functions of the brainstem or of the cerebral cortex. Brainstem disorders can cause coma if the brainstem is compressed by other parts of the brain swollen because of disease or if it is afflicted by local disease such as encephalitis , stroke , or concussion. Diseases of the cerebral cortex causing coma include poisoning by sedative drugs, lack of glucose or oxygen in the blood , brain hemorrhage , and certain rare infiltrative disorders in which descent through the levels of consciousness occurs over weeks or months.

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Brief periods of unconsciousness, of which the patient may not be aware, occur in many forms of epilepsy , narcolepsy , repeated attacks of low blood sugar, and reduction in the blood supply to the brain—particularly the brainstem. When pressure inside the cranium is increased, pain-sensitive structures in and around the brain are distorted and cause pain in an ill-localized area but often identifiably in the front or back of the head called a traction headache. Traction headaches may be caused by brain swelling, infection, bleeding, tumour , stress, or obstructed flow of cerebrospinal fluid.

Also, pain may be felt in the head region although the disorder causing the pain is situated elsewhere; an example is the facial pain sometimes felt with lack of blood to the heart. Local disease of such cranial structures as the jaw joints, the paranasal sinuses and teeth , the middle ear, and the skull bones themselves may also generate pain.

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Reflects recent shifts toward a multifaceted approach to tumor categorization, including the new World Health Organization Classification of Tumors of the Central Nervous System, in which genetic features are now defining elements for several major categories of CNS tumors. Anticipates changes in CNS tumor classification that are possible in the future. Contains a new chapter on intraoperative consultation as it pertains to CNS specimens, a key topic not usually covered in neuropathology texts.

Nervous System Tumors

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