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8/7/2019 CNS PATH CHART
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Viral!encephalitis! Presents:
1.!Mental!status!change,!fever,!headache,!and!may!progress!to!coma.!
Herpes!simplex!virus:!
1.!Petechial!hemorrhages!in!the!temporal!lobe!(limbic!encephalitis).!
HIV:!
1.!Cerebral!involvement!leads!to!AIDS!dementia!complex.!
2.!Microglial!nodules!and!perivascular!multinucleated!giant!cell.!
3.!Immunosupression!may!lead!to!toxoplasmosis!and/or!CNS!lymphoma.!
Rabies:!
1.!Negri!bodies!in!cytoplasm!of !affected!cells,!usually!hippocampal!and!Purkinje!cells.!
2.!Virus!travels!intra"axonally!from!animal!bite!to!CNS!to!cause!symptoms.!Progressive!multifocal!!leukoencephalopathy!(PML):!
1.!JC!virus!causes!PML!in!immunocomprimised!(especially!AIDS).!
2.!Astrocytes!acquire!bizarre!nuclei!and!large!shapes.!
3.!Oligodendrocytes!in!active!lesions!contain!viral!intranuclear!inclusions.!
!!
!!
1.!Herpes!simplex!virus:
!
2.!Rabies:!
! !
3.!PML:!ground !glass"appearance"
! !
!
Cerebral!abscess!
1.!Occur!in!patients!who!have!had!infective!endocarditis,!
cyanotic!heart!disease!(right"to"left!shunt),!or!chronic!
pulmonary!abscess.!
2.!Also!wound!infections,!mastoiditis,!paranasal!sinusitis,!
acute!otitis,!open!fracture,!previous!neurosurgery.!
3.!Are!not!associated!with!prions!and!viruses.!
1.!Hematogenous!dissemination!or!direct!spread!
from!contiguous!foci.!!!
2.!Increased!intracranial!pressure:!headache!
vomiting,!and!papilledema.!
Toxoplasmosis:!
1.!Infection!is!result!of !oocyst!ingestion!shed!in!
cat!feces.!
2.!Transplacental!infection!of !fetus!with!
neurologic!consequences!may!occur.!
3.!In!AIDS!patients!intracerebral!mass!lesions!
(central!necrosis!and!chronic!inflammation)!may!
be!present!
Amoebic!abscess:!
1.!Infection!occurs!via!nose!from!fresh!water!or!
from!ingestion.!
2.!Nasal!invasion!results!in!an!acute,!rapidly!
progressive!abscess!and!can!lead!to!death!if !not!
treated.!
3.!Enteric!invasion!is!a!slower!progression.!
CT/MRI:
1.!Ring"enhancing!lesion.!
!
1.!Each!cyst!is!filled!with!bradyzoites,!and!are!called!tachyzoites!when!
present!ouside!the!cyst.!
!
1.!Amoeba!have!a!granular!cytoplasm!with!a!nucleus!with!a!
nucleolus.!
!! !
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