CNS Diseases

Clinical features:

Systemic signs of infection superimposed on clinical evidence of meningeal irritation and

neurologic impairment
Headache, photophobia, irritability, clouding of consciousness, & neck stiffness
Waterhouse-Friderichsen syndrome
Meningitis- associated septicemia with hemorrhagic infarction of the adrenal
glands and cutaneous petechiae
Most often occurs with meningococcal and pneumococcal meningitis
Meningioma
Lesion:
Meningioma- benign tumors of adults, usually
attached to the dura, that arise from the
meningothelial cells of the arachnoid

Etiology:
Gram (-) bacilli; E.coli- most common,
Proteus, Klebsiella, and Enterobacter

Hallmarks:

- Meningioma with whorled pattern of

cell growth
- Psammoma bodies (calcification of the
syncytial nests of meningothelial cells)

Gross:
- Rounded masses with well-defined dural
bases that compress underlying brain but
are easily separated from it
Molecular Genetics:

Most common cytogenic abnormality: loss of long arm of chromosome 22 (specifically

chr 22q12) area that harbors NF2 gene that codes for merlin protein higher
histologic grades and lesser chromosomal stability

Meningiomas without NF2 gene mutation most common mutation involves TNF-
receptor associated factor 7 (TRAF7) lower histologic grade and greater chromosomal
stability