CNS Tutorial

1. Tumours are space occupying lesions (SOL) in the brain. Astrocytoma is the most
common glial tumour in the central nervous system. Glioblastoma is a poorly
differentiated astrocytoma.

1.1.Describe the macroscopic and microscopic features of glioblastoma.

1.2.List two other types of glial tumours.
1.3.List three other types of lesions (other than tumours) which act as space
Occupying lesions in the brain.
1.4.List three types of internal brain herniation that can occur as a result of a
supratentorial space occupying lesion and state the part of the brain that
herniates in each.
1.5.List three other secondary effects of the brain that occur due to SOL other than
Herniation.

2. A 65-year-old man is admitted to emergency department with the complaint of being

found unresponsive on the floor at home. On admission his blood pressure is 140/90
mmHg and pulse rate is 110 bpm with irregularly irregular rhythm. His saturation on
room air is 97%. Neurological examination reveals GCS 5 and forced conjugate gaze
deviation to left(eye ball deviated to left). He is not moving his right upper and
lower limbs. His capillary blood glucose level is 112 mg/dl. He has a past history of
hypertension and ischemic heart disease.
His NCCT brain is given below.

2.1.What is the most likely clinical diagnosis?

2.2.Describe the pathogenesis of above condition.
2.3.What are the risk factors in above patient to develop his condition?
 2.4.Describe the possible morphology of affected site of his brain.

2.5.Describe the pathological effects of hypoxic and ischemic injury to the brain .

3. A 50 year old female presented with sudden severe headache and drowsiness for five
hours. An” ‘intracranial haemorrhage" was suspected. A CT scan showed a subarachnoid
haernorrhage.
3,1, List two (02) possible causes for spontaneous subarachnoid haemorrhage.
3.2. Describe the possible macroscopic changes that would have occurred in this
patient's brain. .
3.3. Name two (O2) possible intracranial complications that could occur in this patient
3.4. Name two (02) other main types of intracranial haemorrhage
3.5. Give two (02) possible causes for each type of intracranial haemorrhage that you
Mentioned in 3.4