CEREBRAL INFLAMMATION Flashcards
What is meningitis?
Inflammation of meninges caused by viral or bacterial infection
What is encephalitis?
Inflammation of the brain caused by infection or autoimmune mechanisms
What is the name given to inflammation of blood vessel wall?
Cerebral vasculitis (sometimes angitis)
What is inflammation of the spinal cord called?
Myelitis
How dense is the vascularisation of CNS?
Very - no neurone is more than 100 um from a capillary
What makes blood brain barrier capillaries special?
They have extensive tight junctions at the endothelial cell-cell contacts massively reducing solute and fluid leak across
What does long term blood brain barrier disruption cause? (capillary endothelial layer disruption)
Fibrosis due to fibrinogen leakage from blood into nervous tissue and collagenous disruption. Causes astrogliosis where astrocytes try to clean up the leakage
What are the symptoms of encephalitis?
Initially:
- flu-like pyrexia
- headache
Hours, days, weeks:
- confusion/disorientation
- seizures/fits
- changes to personality/behaviour
- difficulty speaking
- weakness/loss of movement
- loss of consciousness
Why can a loss of consciousness occur in encephalitis?
If inflammation unchecked can reach brainstem
What are the 4 most common viruses which cause encephalitis?
Herpes simplex
Measles
Varicella (chicken pox)
Rubella
How and what are the treatments for encephalitis?
Depends on underlying cause but may include:
- Antivirals e.g. acyclovir
- Steroids (reduce swelling)
- Antibiotics/antifungals
- Analgesics
- Anti-convulsants
- Ventilation
What is the pathology of multiple sclerosis to the CNS?
Inflammation
Demyelination
Axonal loss
Neurodegeneration
What should you look for in the histology of inflammation in MS?
Perivascular immune cell infiltration (CD3 T-cells and CD20 B-cells)
What proportion of infected people does meningitis leave with an impairment?
1/5
What are the common bacterial causes of meningitis?
Meningococcal (most common in UK)
Pneumococcal
Haemophilus influenzae tybe b (Hib)
Streptococcal (main cause in neonates)
