Neuropathology

The Neuropathology is concerned with pathological changes in the central and peripheral nervous system in deceased as well as living patients. Muscle and nerve biopsies are one of the main neuropathological procedures, alongside CSF removal. Germany is the only country in Europe in which neuropathology is an independent branch of pathology.

What is Neuropathology?

Pathology deals with pathological conditions and changes in the body. Neuropathology is a branch of this medical field. It deals with pathological conditions and changes in neurological tissue.

Changes in the central nervous system fall into this area as well as changes in the meninges or the peripheral nerves. In addition to the cerebral cortex and the cerebellum, the cranial nerve nuclei and the spinal cord also play a role in neuropathology. From a European perspective, neuropathology is a separate field of pathology only in Germany. A specialist training in this area qualifies as a neuropathologist throughout Germany.

A distinction must be made between neuropathology and neurology and neurosurgery as well as psychiatry. While these medical sub-areas are practical subjects, neuropathology is a clinical-theoretical subject. The beginnings of neuropathology go back to the 17thCentury and an English doctor named T. Willis. In the 19th century, the neurosciences experienced a heyday and neuropathology established itself as a medical specialty.

Treatments & therapies

Like any other pathology, neuropathology examines the origin and manner of changes in organic tissue. In the neuropathological sub-area, this examination focuses on neurological tissue from the central and peripheral nervous system.

This tissue can correspond to nerve tissue, spinal cord tissue, or brain tissue. Under certain circumstances, however, muscle tissue also falls within the scope of the neuropathologist. In addition to the origin and method of development of the changes, the form and consequences of neurological diseases also play a role in neuropathology. Pathological changes in the neurological system can, for example, be preceded by a neurological degenerative disease. On the other hand, tumors or immunological processes can also cause changes in the central and peripheral nervous system. In addition to the examination of altered tissue in living patients, the autopsy of the deceased plays an important role in neuropathology.

One of the most important parts of the neuropathological range of tasks is research. In the 21st century, neurodegeneration from diseases such as Alzheimer's disease plays a major role in neuropathological research. Neuroimmunology also plays an important role in neuropathological research in the context of diseases such as multiple sclerosis. Neurology and neurosurgery in particular draw on the findings of neuropathology. On the basis of the neuropathological research results, they develop, for example, prophylaxis, diagnostics and therapies for various diseases of the nervous system. The discussion of neuropathological research results and new observations is the order of the day in the theoretical field. As a rule, there are mainly interdisciplinary discussions with colleagues from practical medical fields.

Since neuropathology itself is not practical, but clinical-theoretical, it is not really possible to speak of a range of treatments in this field. Neuropathology takes over the investigation and clarification of neurological diseases. The actual treatment takes place in practical areas such as neurology and neurosurgery. Psychiatry may also be able to handle the treatment. This applies to disorders that, in the context of neuropathological examinations, prove to be independent of pathological changes in the neurological system.

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Diagnosis & examination methods

One of the most important procedures in neuropathology is muscle biopsies. In such a biopsy, the doctor takes pathologically changed muscle tissue from the patient and examines the cause of the change in the laboratory. This method is mainly used when there is suspicion of muscular diseases. Nerve biopsies are also relevant for neuropathology.

The removal of nerve tissue from the neurological system is mostly used to diagnose neurodegenerative diseases. In particular, demyelinating diseases can be diagnosed using the method. Brain biopsies are also performed as part of neuropathology. This type of tissue extraction usually involves drilling a small hole in the skull bone. The doctor inserts a hollow needle into this hole, which he uses to remove tissue. Biopsy tissue is examined biochemically and molecularly genetically in the laboratory. A biopsy, for example, allows the possible causes of the disease to be narrowed down. When taking and examining tumorous changes in the central and peripheral nervous system, neuropathology overlaps with the field of molecular pathology.

This medical field focuses on genomic sequence analysis of tumor cells. In neuropathology, the removal of neurological tissue types can also take place in the course of an autopsy and post-mortem examination. In this context, the tissue sample is primarily used for neuropathological research. Just as important as the removal of muscle, brain and nerve tissue is the collection of CSF samples for neuropathology.

The liquor is also known as brain water and fills the cavities in the brain. This brain water flows from the brain into the outer liquor spaces. Pathological processes in the central nervous system are reflected in the CSF in an increased number of cells or deviating concentrations of other substances. The CSF is taken from the lower CSF space as part of a CSF sample. This CSF space is in the area of ​​the spine and is punctured for removal. The examination of the removed brain water has allowed a leap in the diagnosis of various neurological diseases.