cerebral inflammation Flashcards
How many meningeal layers?
3
where is CSF found
subarachnoid space
What is found in the subarachnoid space?
CSF, blood vessels and immune cells.
What is encephalitis?
Inflammation of the brain due to infection or autoimmune cause
What is meningitis?
Inflammation of the meningeal layers due to infection
What is cerebral vasculitis?
Inflammation of the blood vessel walls of the brain
What is myelitis?
inflammation of spinal cord within CNS
What is the vascularisiation of the CNS like?
Very dense and extensive vascularisation. Cells very close to capillaries.
What do pial vessels do?
Pial vessels extend in brain
What is the BBB like and why? How is transport usually across BBB?
- BBB very tight has tight junctions between endothelial cells to prevent leakage of substances or substances that shouldn’t enter.
- Transport usually by active transport by transporters on the BBB
What do perivascular glial cells (astrocytes) usually do?
Astrocytes have many functions, contribute to structure of BBB and are neuroprotective
What does the tightness of BBB capillaries mean for infectious agents and how is BBB exchange of substances achieved?
infectious blood borne agents cannot pass and BBB exchange of substances achieved by active transporters.
What does physical breach of the BBB cause? What can happen in the long-term?
- Physical breach of BBB causes leakage of the blood substances into the brain.
- Endothelial layer disruption & collagen disruption, fibrinogen leakage causes reaction in astrocytes to try to clear blood borne products.
- Long-term this can cause fibrosis due to the damage of the blood vessels
What are the symptoms of encephalitis? How do they usually present ?
? Usually present initially with flu like symptoms (cold & fever) and later after week present with confusion, altered mental state, seizures, difficulty speaking, changes in personality, loss of consciousness
What is the cause of encephalitis? What are some causative agents?
Usually viral infections (herpes simplex, measles, chicken pox). Can also be due to other causes like fungal/bacterial infections, autoimmune or trauma.
What is treatment for encephalitis?
Depends on cause - can be antivirals, antibiotics, antifungals, analgesics for pain, steroids for inflammation, anti-convulsants for prophylaxis.
What is multiple sclerosis MS?
Degenerative condition where autoantibodies attack the myelin of neurones which are responsible for saltatory conduction and and they get demyelination. Present with neurological deficits and later a completely different neurological presentation. Progression linked to neurodegeneration. Can have inflammatory demyelination too.
What is seen on brown stain in MS? What is seen in white matter?
- big holes on brown stain
- large areas of discolouration in white matter
Why can symptoms vary in MS?
Very heterogenous because can present in different areas of the body and therefore cause different presentations/deficits
What are some cells that infiltrate in MS and where do they infiltrate?
CD8, CD20, CD3 - perivascular immune infiltration
What is meningitis?
Inflammation of the meningeal layers of the brain
How many people does meningitis leave with impairment?
1 in 5
What can happen in neonates with meningitis?
developmental problems
How does meningitis present?
sudden fever, headache, confusion, photophobia, stiff neck, rash, double vision, nausea
hat are common causes of meningitis?
Usually bacterial (meningococcal, pneumococcal, streptococcal (most common in neonates), haemophilus influenza type B), sometimes viral (rarely dangerous), fungal
What should the treatment be?
quick IV antibiotics before diagnosis because very dangerous
What diagnostic tests can be done for meningitis and what would be seen?
MRI, CSF (would see clear/colourless CSF with low glucose in bacterial meningitis, raised WCC), CT, bloods, urine analysis
