Metabolic, toxic, and nutritional diseases.

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Metabolic, toxic, and nutritional diseases.

Last updated on Sunday, July 20 2008 by jdmiles

Related images:

Acute Lead Encephalopathy, Dorsal surface of brain.
Exposure to high levels of inorganic lead may produce diffuse cerebral edema as seen here

Superior cerebellar degeneration, sagittal midline section of cerebellum
Degeneration of the superior cerebellar vermis is classically seen as a manifestation of chronic alcohol use, but may also be seen in other defects in energy metabolism

Grinker Myelinopathy
White matter destruction may be delayed after exposure to carbon monoxide, resulting in delayed neurological deterioration. Similar lesions may be produced experimentally by cyanide administration

Grinker Myelinopathy, Close Up of coronal section of brain
Demyelination and necrosis of subcortical white matter following carbon monoxide intoxication

Acute methyl bromide toxicity, coronal section of brain, close up
Methyl bromide was used at one time for fumigation. Human exposure could result in diffuse cerebral edema with petechial hemorrhag and neuronal loss

Late-delayed radiation necrosis, coronal section of brain
White matter necrosis secondary to vascular damage by radiation.

Late-delayed radiation necrosis, coronal section of brain
In coagulopathic patients, radiation necrosis may become hemorrhagic

Bilateral pallidal necrosis
Though bilateral necrosis of the globus pallidus has been classically associated with carbon monoxide intoxication, identical pathologic changes can be seen in patients surviving severe systemic hypotension.

Grinkers Myelinopathy, crimbring stain for myelin
Perivascular myelin loss is typically seen as a delayed reaction to carbon monoxide intoxication. Corpus callosum runs along the bottom of the picture, with deep pale stains cingulate gyrus to the left

Grinkers Myelinopathy, Crimbring stain for myelin, high-power
Myelin staining demonstrates perivascular pattern similar to that seen in acute disseminated encephalomyelitis. On H&E stain, ADEM demonstrates associated perivenular inflammation, which is not seen in carbon monoxide toxicity.

Late-delayed radiation necrosis, low power H&E stain through cerebral cortex and white matter.
Cerebral cortex appears well-preserved. Underlying white matter demonstrates cavitary necrosis.

Related review questions:

Neurologic Sequellae of Nutritional Deficiencies 01
This MRI most likely comes from a patient with which of the following findings

Neurologic Sequellae of Nutritional Deficiencies 02
The pathologic findings in this MRI are most likely related to a disease state resulting from a deficit of which nutrient

Neurologic Sequellae of Nutritional Deficiencies 03
A 57 year-old man presents with worsening confusion, ataxia, nystagmus, and ophthalmoparesis. An MRI of his brain is obtained, and is shown above.Appropriate treatment requires IV administration of which of following

Review of the relevant anatomy

Wernicke Encephalopathy