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
what are the causes of meningitis?
bacteria viruses (rarely life threatening) fungi
26
how is meningitis diagnosed?
lumbar puncture for CSF sample
27
what are the hallmarks of meningitis?
sudden onset of fever, headache, nausea, double vision, photophobia, stiff neck, rash
28
what are some long term effects of meningitis? (7)
``` disabilities memory loss coordination loss behaviour changes paralysis/weakness speech coord issues visual defects ```
29
what diagnostic tests are useful for suspected encephalitis or meningitis?
lumbar puncture - raised WCC, pink colour low csf glucose in bacterial men CT/MRI neurological assessment
30
What is an infection of the spinal cord known as?
myelitis
31
What types of infections can cause encephalitis and meningitis?
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
What are some hallmarks of encephalitis and meningitis?
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
What diagnostic tests can be performed for encephaltiis, meningits and multiple sclerosis?
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
What are some of the long term effects of meningitis?
**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. **