Diseases of the Nervous System

Fangying Xu

xfyzjueducn

神经系统病理

感染性疾病

感染途径血源性感染脓毒血症局部扩散如中耳炎直接感染如创伤或医源性经神经感染单纯疱疹病毒沿三叉神经入侵

细菌性疾病病毒性疾病海绵状脑病

细菌性疾病

脑脓肿 (brain abscess) 脑膜炎 (meningitis)

硬脑膜炎 (pachymeningitis) 继发于颅内感染软脑膜炎 (leptomeningitis) 蛛网膜软脑膜及脑脊液的感染化脓性脑膜炎细菌为主淋巴细胞性脑膜炎病毒感染慢性肉芽肿性脑膜炎由结核杆菌等引起

EPIDEMIC CEREBROSPINAL MENIGITIS

( 流行性脑脊髓膜炎）

Definition

Acute purulent inflammation of leptomeningitis

subarachnoid space and the spinal meninges

caused by meningococcus （脑膜炎双球菌 Neisseria meningitidis)

Etiology

Generally pyogenic meningitis may be caused by

Meningococcus( 脑膜双球菌） pneumococci （肺炎双球菌）

streptococci （链球菌） Staphylococci （葡萄球菌）

influenza bacilli （流感细菌） actinomyces （放线菌） and

rarely colon bacilli in infants

The most important of these is the meningococcus

脑膜炎双球菌（学名 Neisseria meningitidis ）又名脑膜炎奈瑟菌或脑脊髓膜炎双球菌简称为脑膜炎球菌是一种革兰氏阴性菌 1887 年 Weichselbaum 首次从脑脊液中分离出

内毒素细菌表面成分菌毛粘附器感染性强但对外界的抵抗力较弱存活能力差本菌含

自溶酶如不及时接种易溶解死亡对寒冷干燥较敏感低于 35 加温至 50 或一般的

消毒剂即可杀死

Epidemic features

Source of infectionPatient in disease

Pathogen carrier without symptoms50 in normal persons could be found with Neisseria

meningitidis in epidemic season

Route of transmissionAir transmission eg by cough sneezingIntimate touch eg kiss breast-feeding

Susceptible population 6 months old ndash2 years old in peaksusceptible population

Epidemic season most in spring and winter

Pathogenesis

（脑脊髓膜炎期）

（败血症）期

（上呼吸道感染期）

（化脓性脑膜炎）

（沃 - 弗综合征）

Morphology

Grossly

An exudate is evident within the

leptomeninges over the surface of the brain

The meningeal vessels are engorged and

stand out prominently

A Pathological features of purulent meningitis

软脑膜及蛛网膜下腔可见大量脓性渗出物血管扩张充血

Microscopically

1048698 The subarachnoid space contains purulent exudates

with varying amounts of fibrin

1048698 In most severe cases the entire subarachnoid space

is filled with purulent exudates

1048698 In less severely affected cases only the tissue

around the leptomeningeal blood vessels contains cells

蛛网膜下腔间隙增宽毛细血管扩张大量炎性渗出物积聚

炎性渗出物以大量中性粒细胞和纤维蛋白渗出为主及少量淋巴细胞单核细胞浸润

B Pathological features of fulminant meningitis

In fulminant infections apparent sepsis symptom and

signs appear with the less severely purulent exudates

around the leptomeningeal and subarachnoid space

even without meningeal inflammation

Fulminant meningitis could be divided into

Shock type and meningitis-encephalitis type

Pathological features of fulminant meningitis

1 Shock type

Waterhouse Friderichsen syndrome （沃 - 弗综合征 ) 两侧肾上腺严重出血肾上腺皮质功能衰竭表现为周围循环衰竭休克和皮肤大片紫癜机制大量内毒素释放引起的 DIC

A group of shock symptomsHigh fever and chill Headache and vomitingSkin eruption ( petechia and ecchymosis)The cold extremities and palenessWeak pulse and low pressureDIC (disseminated intravascular coagulation)

2 Meningitis-encephalitis type 脑膜脑炎A group of symptoms involving damages of central nervous system accompanied with the tri-signs in infectious diseases heavy headache high pyrexia and vomiting

脑实质损害的临床症状明显患者迅速进入昏迷嗜睡惊厥频繁锥体束征常阳性两侧反射不等血压持续升高眼底可见视乳头水肿部分病人发展为脑疝瞳孔明显缩小或散大或忽大忽小

1)Signs of meningeal irritation( 脑膜刺激症状）

2)Increased intracranial pressure （颅内压升高症状）

3)Changes of cerebrospinal fluid (CSF) （脑脊液改变）

Clinicopathologic association

1)Signs of meningeal irritation

Heavy headacheOpisthotonus （角弓反征）Kernig sign+ （屈髋伸膝征阳性）Stiff neck （颈项强直）

Clouding of consciousness

Stiff neck

2) Increased intracranial pressure 头痛喷射性呕吐脑疝形成小儿前囟饱满

Some degree of acute internal hydrocephalus results from an increased permeability of the choroids plexus an outpouring of exudates into the ventricular

This condition along with edema congestion of blood vessels and subarachnoid exudates increases the intracranial pressure which causes tri-signs in intracranial pressure heavy headache and dizzinessjetting-vomiting and hernia formation

侧卧位脑脊液压超过 20Kpa （正常 06-08Kpa ）

In fulminant infection bacteria may sometimes be visible on smear or be readily cultured for a few hours before polymorphos appear

结局和并发症

脑积水脑神经受损麻痹 IIIIVV （三叉神经） VI

（展神经）和 VII （面神经）动眼神经（ III ）麻痹表现为上睑下垂眼球外斜向上外上内

下内同侧方向运动障碍瞳孔散大对光反应及调节反应消失

滑车神经（ IV ）麻痹表现为眼球不能向下外方向运动伴有复视头呈特殊位呈下颏向下头面向健侧的姿势

脑缺血和梗死

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80以上的中枢神经系统病毒感染是由肠道病毒 (enteroviruses) 引起的包括柯萨奇病毒（ Coxsackie virus ）埃可病毒 (ECHO virus) 脊髓灰质炎病毒 (polio-virus) 等其次是疱疹病毒（ herpes virus ）水痘 -带状疱疹病毒（ varicella-zoster virus ）巨细胞病毒（ cytomegalovirusCMV ）等呼吸道病毒（ respiratory virus ）麻疹病毒 (measles virus)

风疹病毒 (rubella virus) 狂犬病病毒 (rabies virus) 腮腺炎病毒 (mumps virus)

和虫媒病毒等也可引起

病毒性疾病

中枢神经系统病毒感染的特点绝对细胞内寄生不同病毒定位于不同细胞或核团

疱疹病毒颞叶及顶叶眶部病毒感染的细胞出现细胞溶解小胶质细胞增生形成结节多核巨细

胞形成

包涵体胞质或胞核中狂犬病毒时的 Negri 小体炎症细胞以淋巴细胞巨噬细胞和浆细胞为主形成袖套现象 (vascula

r cuffing)

Type B Epidemic Encephalitis

（流行性乙型脑炎）

乙型脑炎病毒感染所致的急性传染病多在夏秋季流行

高热嗜睡抽搐昏迷等

10岁以下儿童多见约占 50-70

全国乙脑报告病例数每年在 5000～ 10000例之间但局部地区时有暴发或流行而全世界病例数每年高达 50000

例死亡数 15000例

A great many viruses may cause epidemic encephalitis

In China India Southeast Asia and Korea as well as Japan epidemic

encephalitis is caused be a flavirus(黄病毒 ) Japanese encephalitis viru

s

In order to distinguish it from von Economorsquos(A) type encephalitis it was named Japanese encephalitis B or epidemic encephalitis B

乙型脑炎病毒属披膜病毒科黄病毒属第 1亚群呈球形直径 20～ 40nm为单股 RNA 病毒

Etiology

104869810486981048698

Sources of infectionRoute of transmissionSusceptible populationEpidemic season

1048698 Pigs cows sheep dogs chicken duck and goose infected

1048698

Vector mosquito [库蚊 (Culex) 伊蚊 (Aedes) 和按蚊 (Anopheles)]

It has a seasonal incidence and mosquito vector mainly

occurring in summer and often affecting the children (most of 2-

7years of age)

Epidemics

Morphology

Mainly involves cerebrospinal parenchyma

Gross appearance softening area in cerebral parenchyma esp

ecially in cortical

粟粒或针尖大小的半透明软化灶皮质深层基底核视丘等处最严重其次是小脑皮质延髓及脑桥脊髓病变最轻

软化灶

Morphology

Microscopically

Degeneration and necrosis of neurocyte （神经细胞变性坏死）

Softening area formation （软化灶形成）

Perivascular inflammatory cell infiltration （脑血管改变）

Proliferation of microgliacyte （胶质细胞增生）

1 Degeneration and necrosis of neurons

Neuronophagia phenomenon (噬神经细胞现象 )

individual neuron necrosis and phagocytosis by microglial cells

小胶质细胞或血源性巨噬细胞包围吞噬坏死神经元后可形成泡沫细胞或格子细胞

Satellite phenomenon( 神经细胞卫星现象）1个神经元由 5个或以上少突胶质细胞（ oligodendrocyte) 围绕

Microscopically

Necrosis of neurons

神经元肿胀尼氏小体消失胞质内空泡形成核偏位或固缩溶解消失

噬神经细胞现象

2 Softening area formation

Focal neuronal necrosis and show a loose light-stain sieve structure

软化灶灶性神经组织坏死液化形成镂空状筛网状结构具诊断价值

软化灶

3 Perivascular inflammatory cell infiltration

1048698 The most characteristic histological change in acute viral

disease is a mononuclear cell infiltrate (lymphocytes

plasma cells and macrophages) generally located around

blood vessels (perivascular cuffing)

血管扩张周围间隙增宽浸润的炎症细胞形成血管套

Perivascular cuffing

4 Proliferation of microgliacyte Microglial nodules

1048698

The presence of glialnodules and neuronophagia

(individual neuron necrosis and phagocytosis) also

suggests viral disease

另外少突胶质细胞增生明显

星形胶质细胞增生和胶质瘢痕形成

小胶质细胞结节

The presence of glialnodules

The clinical Courses

最早和主要的症状嗜睡昏迷脑神经麻痹症状脑水肿和颅内压升高脑疝（ brain hernia ）小脑扁桃体疝脑膜刺激征

实验室检查外周血检测白细胞总数常在 1万～ 2万 mm3 中性粒细胞在 80

以上脑脊液无色透明压力仅轻度增高白细胞计数增加病初 2～3天以中性粒细胞为主以后则单核细胞增多为主糖正常或偏高蛋白质常轻度增高

结局急性期痊愈数月后恢复正常后遗症痴呆语言障碍肢体瘫痪等

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感染性疾病

感染途径血源性感染脓毒血症局部扩散如中耳炎直接感染如创伤或医源性经神经感染单纯疱疹病毒沿三叉神经入侵

细菌性疾病病毒性疾病海绵状脑病

细菌性疾病

Definition

Etiology

Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

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LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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细菌性疾病

Definition

Etiology

Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Definition

Etiology

Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Etiology

Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Epidemic features

Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Pathogenesis

（败血症）期

Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Morphology

Grossly

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 50

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Microscopically

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 3
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Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 40
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Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 3
Slide 4
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

1 Shock type

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

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Slide 41
Slide 42
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Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
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Slide 3
Slide 4
Slide 5
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
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Slide 3
Slide 4
Slide 5
Slide 6
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
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Slide 3
Slide 4
Slide 5
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Stiff neck

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
Slide 9
Slide 10
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
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Slide 10
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

结局和并发症

脑缺血和梗死

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
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Slide 47
Slide 48
Slide 49
Slide 50

wwwthemegallerycom

LOGO

病毒性疾病

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

胞形成

r cuffing)

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
Slide 9
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
Slide 9
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

s

Etiology

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

104869810486981048698

1048698

7years of age)

Epidemics

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
Slide 9
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Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Morphology

ecially in cortical

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

软化灶

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
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Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Morphology

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
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Slide 38
Slide 39
Slide 40
Slide 41
Slide 42
Slide 43
Slide 44
Slide 45
Slide 46
Slide 47
Slide 48
Slide 49
Slide 50

Microscopically

Necrosis of neurons

软化灶

1048698

Slide 1
Slide 2
Slide 3
Slide 4
Slide 5
Slide 6
Slide 7
Slide 8
Slide 9
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Necrosis of neurons

软化灶

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软化灶

1048698

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软化灶

1048698

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软化灶

1048698

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1048698

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1048698

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1048698

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1048698

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Date post:	02-Jan-2016
Category:	Documents
Upload:	fitzgerald-trevino
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