Pathology of CNS

europathology

Oleh:
Dr. Cahyono Kaelan, Ph.D, Sp.PA(K), Sp.S

Topics
1.Introduction to Neuroanatomy
2.Neuronal Degeneration
3.Congenital Abnormality
(Hydrocephalus)
4. Strokes (HS & NHS)
5. Infection ( Encephalitis, Meningitis)
6. CNS Tumors
7.Degenerative CNS Diseases (AD &

The anatomy of the brain

CNS Cellular

Neuron
Astrocytes
Oligodendroglia
Microglia
Ependym

NEURONAL
DEGENERATION

Neuronal Degeneration
Chromatolysis:
is the dissolution of
the Nissl bodies in the
cell body of a neuron.

Neurolysis:
the breaking down of
nervous tissue (as
from disease or
injury)

Neurophagia:
phagocytoses by
microglia

CONGENITAL
ABNORMALITY
(HYDROCEPHALUS)

Congenital Abnormality
(Hydrocephalus)

Hydro
= Water
Cephalus = Head
Infection within during pregnancy
Disturbing of CSF circulation

STROKE

Stroke

HS =
Hemorrhagic
stroke
NHS = Non
Hemorrhagic
stroke

HS

NHS
Thrombus
Emboli lepas akbt atrial fibrillasi,
penyakit jantung
Atherosclerosis =Perkapuran p.darah
DM
Hyperlipidaemia
Hypertensi
Dyscrasia darah (gangguan darah)

INFECTION
( ENCEPHALITIS,
MENINGITIS)

Infeksi ( Meningitis, Encephalitis )

Radang selaput meninges

M-Purulenta
M-TBC
Panas tinggi
Kejang-kejang
Kesadaran menurun
Kaku kuduk
Slide ( Praktikum Meningitis
Purulenta)

TUMORS

CNS Tumors
(Neoplasma sesuai asalnya)

Astrocytoma
Schwannoma
Oligodendroglioma
Ependymoma
Choroid plexius papiloma
Meningioma

Astrositoma Grade 1
Astrosito
ma pilositic
berupa kistik
dengan cairan
kuning
kecoklatan dan
adanya nodul
mural (mural
nodule).

 Sel

Sign and symptom

Slow growing, and may grow to a large size before
causing symptoms.
The symptoms will depend on the location
The first symptoms are usually due to increased
pressure on the brain caused by the growing
tumor.
Headache and weakness in an arm or leg are the
most common, although seizures, personality
changes, or visual problems may also occur.
Pain and loss of sensation or weakness in the arms
or legs are the most common symptoms of spinal
cord meningioma.
Most people with meningiomas will have no
symptoms.

Tekanan intra kranial &

Herniasi
Penyebab Peninggian TIK :
Brain edema, Tumor, Stroke (HS dan
NHS), Hydrocephalus, Trauma
Perdarahan.
TIK meninggi Herniasi (Penurunan
bagian otak ke bagian bawah / celah
Herniasi menekan batang otak
pusat pernapasan dan Jantung
Kematian

Herniation
Supratentorial herniation
1. Uncal (transtentorial)
2. Central
3. Cingulate (subfalcine)
4. Transcalvarial
Infratentorial herniation
5. Upward (upward cerebellar
orupwardtranstentorial)
6. Tonsillar (downward
cerebellar)

DEGENERATIVE DISEASE
(ALZHEIMERS DISEASE DAN PARKINSON
DISEASE)

Pathology
AD (Alzheimers Disease)

Atrofi lobus frontalis d temporalis

Parkinson Disease

Gejala (TRAP)
Tremor : resting tremor
Rigidity : cogwheel
phenomena (gerakan pasif,
terputus2 dan langkah jalan
cepat tp pendek (festination)
Akinesia: mask face,
hipofonia, drooling,
mikrografia) dll
Postural reflex terganggu: pull
test

Gejala tambahan
motorik: freezing (bhenti
ditempat saat mau
melangkah, sdg berjalan),
start hesitation (ragu2
mulai melangkah), distonia
ddl
Otonom: konstipasi,
impotensi seksual
Mental: lambat berpikir,
depresi, dementia
Lain-lain:

Pathogenesis
Degenerative (old), > 65 tahun
Genetics
Traumatic (repetitive injury /
Pugulistic)
Post infections (Encephalitis)
Parkinsonism= Parkinson akibat
obat2an /psikotropika= usia muda
(Bedakan dgn real PD)

Pathology PD

Mid brain
Kerusakan Subtantia Nigra
Pigmented neuron
Levy body
Gliosis

for the attention