At the completion of this unit, the student will be able to ...

1. Understand:
   • The role of cerebro-vascular diseases in terms of mortality and morbidity in the United States.
   • The spectrum of anoxic damage to neurons (asphyxia, cardiac arrest, very low blood pressure, vascular occlusion).
   • The spectrum of causes for vascular occlusion of cerebral arteries (thrombosis, embolism, vasculitis, atherosclerosis, external compression, spasm).
   • Consequences of venous occlusion.
   • Septic and sterile sinus thrombosis.

2. Know the usual etiologies and pathogenesis for
   • epidural hemorrhage
   • subdural hemorrhage
   • subarachnoidal hemorrhage
   • intracerebral hemorrhage

3. Understand the nature of aneurysms of cerebral blood vessels
   • congenital "berry" aneurysms
   • atherosclerotic aneurysms
   • "mycotic" aneurysms (are they usually fungal in character?)

4. Know the different types of cerebral edema (vasogenic, cytotoxic, "interstitial", i.e., trans-ependymal)

5. Understand the most important types of cerebral herniation (subfalcial, uncal, cerebellar tonsillar)

6. The diagnostic and ophthalmological significance of papilledema, or "choked" disc.

7. Know the most common bacterial agents causing purulent meningitis and their prevalence in different age groups

8. Understand the pathogenesis of brain abscesses (direct extension from infection in neighborhood, e.g., middle ear-mastoid, paranasal sinuses, open wounds, versus hematogenous, particularly from endocarditis and bronchial-pulmonary infections). Why does the tetralogy of Fallot predispose to brain abscesses?

9. What are the important gross and microscopic differences between bacterial and viral infections of the CNS?

10. Understand the pathological and clinical features of CNS infection/infestation by
    • Herpes simples
    • rabies
    • measles (SSPE)
    • HIV
    • cytomegalovirus
    • Toxoplasma gondii
    • malaria
    • free-living amebae
    • rickettsiae
    • Borrelia burgdorferi
    • Taenia solium
    • Treponema pallidum
    • poliomyelitis
    • PAPOVA (e.g., JC) virus

11. Understand the basic differences between intracranial and visceral neoplasms (most important one being that benign neoplasms when growing intracranially can become just as fatal as the malignant ones if not removed in a timely fashion).

12. Know the names and biological behavior of the most common glial neoplasms.

13. Understand the localization, and biological behavior of meningiomas.

14. Understand the age prevalence, biological behavior and treatment possibilities for
    • medulloblastomas
    • germ cell tumors of the CNS
    • intracranial schwannomas
    • epidermoid cysts, dermoid cysts
    • hemangioblastomas

15. Know the most common tumors that give rise to metastases to the brain, skull, and vertebrae.

16. Understand the pathogenesis of involvement of the brain and meninges in leukemias and malignant lymphomas.

17. Define the listed Keywords.

18. Be able to identify, from projected slides, each of the diseases/processes in the Supplemental Image Database.