1b// Cerebral inflammation & disorders Flashcards

1
Q

what is meningitis?

A

inflammation of the meninges caused by viral or bacterial infection

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2
Q

what is encephalitis?

A

inflammation of the brain caused by infection or autoimmune mechanisms

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3
Q

what is cerebral vasculitis?

A

inflammation of blood vessel walls

aka angiitis

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4
Q

What led to the suggestion fothe blood brain barrier?

A
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5
Q

How would you desribe the vascularisation of the CNS?

A

dense, no neurton is more than 100 micro m from a capillary

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6
Q

What do BBB capillaries have?

A

BBB capillaries have extensive tight junctions at the endothelial cell-cell contacts, massively reducing solute and fluid leak across the capillary wall

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7
Q

what does the histology of meningitis look like?

A

infiltration of subarachnoid space by WBCs, pussy exudate

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8
Q

what does the histology of viral encephalitis look like?

A

perivascular cuffing

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9
Q

how vascularised is the brain?

A

no neuron is more than 100micrometers from a capillary

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10
Q

how does the BBB form?

A

BBB capillaries have extensive tight junctions at endothelial cell-cell contacts, nothing can freely diffuse

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11
Q

what happens if the BBB is broken?

A

blood leaks into brain, astrocytes attempt to clear blood borne products by retracting end feet (leaving BBB undefended)

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12
Q

what may happen long term if the BBB is chronically disrupted?

A

fibrosis in brain vessels, small vessel disease

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13
Q

what are the initial symptoms of encephalitis?

A

flu like with pyrexia and headache

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14
Q

what are the overall symptoms of encephalitis? (7)

A
confusion/disorientation
seizures or fits 
depending on lobe affected:
changes in personality/behaviour
difficulty speaking
weakness or loss of movement
loss of consciousness 
catatonicity

within hours, days or weeks

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15
Q

what are the viral causes of encephalitis? (4)

A

herpex simplex
measles
varicella
rubella

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16
Q

what are the non-viral causes of encephalitis?

A

mosquito/insect bites
bacterial or fungal infections - untreated meningitis
trauma
autoimmune

17
Q

how is encephalitis treated?

A
depends on underlying cause:
antivirals/antibiotics/antifungals
steroids
analgesics
anti-convulsants (often prophylactically)
ventilation
18
Q

what is multiple sclerosis?

A

demyelinating autoimmune disease of the CNS

relapsing and remitting - 1st resolves spontaneously

19
Q

What is relapse and progression of multiple sclerosis linked to?

A

relapse= inflammatory activity
progression= neurodegeneration

20
Q

what is the cellular pathology of multiple sclerosis?

A

inflammation
demyelination & axonal loss (larger grey areas)
neurodegeneration

21
Q

Why do symptoms vary in multiple sclerosis?

A

Symptoms vary because the amount and location of damage to the nervous system is different in each person with MS

22
Q

What happens during inflammation in multiple slcerosis?

A

perivascular immune cell infiltration (CD3 T cell and CD20 B cells)

23
Q

What is meningitis?

A

Irritation, inflammation and swelling of the meninges

6th most common infectious disease killer
Leaves 1 in 5 of the infected people with an
impairment

24
Q

what are the bacterial causes of meningitis?

A

meningococcal (most common)
pneumococcal
haemophilus influenzae type B
streptococcal (main cause in newborns)

25
Q

what are the causes of meningitis?

A

bacteria
viruses (rarely life threatening)
fungi

26
Q

how is meningitis diagnosed?

A

lumbar puncture for CSF sample

27
Q

what are the hallmarks of meningitis?

A

sudden onset of fever, headache, nausea, double vision, photophobia, stiff neck, rash

28
Q

what are some long term effects of meningitis? (7)

A
disabilities
memory loss
coordination loss
behaviour changes
paralysis/weakness
speech coord issues
visual defects
29
Q

what diagnostic tests are useful for suspected encephalitis or meningitis?

A

lumbar puncture - raised WCC, pink colour
low csf glucose in bacterial men
CT/MRI
neurological assessment

30
Q

What is an infection of the spinal cord known as?

A

myelitis

31
Q

What types of infections can cause encephalitis and meningitis?

A

Encephalitis: more commonly viruses (e.g. Herpes Simplex, measles, varicella (chickenpox), rubella (German measles).

Meningitis: more commonly bacteria which initially cause an upper respiratory tract infection and then travel through the blood to the brain. Types of meningitis include (most serious is pneumococcal - streptococcus pneumoniae; meningococcal - Neisseria meningitides; Haemophilus influenzae meningitis caused by Haemophilus influenzae b– reduced by Hib vaccination, previously a leading cause in children under 5).

32
Q

What are some hallmarks of encephalitis and meningitis?

A

Encephalitis: fever, seizures, change in behaviour, and confusion and disorientation.

Meningitis: sudden fever, severe headache, nausea or vomiting, double vision, drowsiness, sensitivity to bright light, and a stiff neck, rash (not always).

33
Q

What diagnostic tests can be performed for encephaltiis, meningits and multiple sclerosis?

A

Neurological examination, CT, MRI, lumbar puncture (CSF is usually clear and colourless; low glucose in bacterial meningitis; raised white blood cell counts are a sign of inflammation), blood, urine analysis.

34
Q

What are some of the long term effects of meningitis?

A

**Long term learning disabilities, memory loss, poor concentration, clumsiness/co-ordination problems, headaches, deafness/hearing problems/tinnitus/dizziness/loss of balance, epilepsy, weakness/paralysis/spasms, speech problems, visual problems.
**