Cerebral Inflammation Flashcards
What are the 3 main types of cerebral inflammation?
- Meningitis
- Encephalitis
- Cerebral vasculitis
Define meningitis.
Inflammation of the meninges caused by viral or bacterial infection
Define encephalitis.
Inflammation of the brain caused by infection or autoimmune mechanisms
How is encephalitis diagnosed (2)?
- CT / MRI scan (brain inflammation or abnormalities)
- Lumbar puncture (Increased WBC count)
Define cerebral vasculitis.
Inflammation of blood vessels walls (angiitis)
There is cuffing, infiltration of lymphocytic cells around the vessels into the parenchyma of the brain
What is myolitis?
- Inflammation of the spinal cord
What type of junctions form the blood brain barrier?
- Tight junctions
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What is the function of the blood brain barrier?
Control the exchange of substances using specific membrane transporters to transport into and out of the CNS
What type of transporters control the exchange of solutes within the blood brain barrier?
- Efflux and influx transporters
Which type of glial cells maintains the structure of the blood-brain barrier?
- Astrocytes
Fibrinogen leakage into the brain parenchyma results in what physiological response?
- Astrocytes undergo astrogliosis, forming a glial scar
- The retraction of the astrocytic end feet potentiates further disruption to the blood brain barrier, resulting in collagenous disruption
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Describe the vascularisation of the CNS?
- Dense capillaries and pial vessels
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What are the initial symptoms of encephalitis (2)?
- Pyrexia
- Headache
What are the subsequent symptoms associated with encephalitis (6)?
- Confusion or disorientation
- Seizures or fits
- Changes in personality and behaviour
- Difficulty speaking (dysphasia)
- Weakness or loss of movement
- Loss of consciousness
What are the common viral causes of encephalitis (4)?
- Herpes simplex
- Measles
- Varicella
- Rubella
What are the non-viral causes of encephalitis (4)?
- Mosquito, tick and other insect bites
- Bacterial and fungal infections
- Trauma
- Autoimmune
What are the treatments for encephalitis (4)?
- Depending on cause: Antivirals (acyclovir) / Steroids / Antibiotics / Antifungals
- Analgesics
- Anti-convulsants
- Ventilation
What is MS?
- An autoimmune demyelinating disease of the CNS
What is MS relapse linked with?
- Linked with inflammatory activity
What are some of the main symptoms of MS (5)?
- Blurred vision
- Fatigue
- Difficulty walking
- Numbness or tingling (paraesthesia) in different parts of the body
- Muscle stiffness & spasms
What is the cellular pathology in MS (4)?
- Changes in periventricular white matter progressively worsen with an ongoing relapsing demyelinating process
- Inflammation
- Demyelination
- Axonal loss
- Neurodegeneration
Describe the symptom and pathology distribution within patients with MS?
- Vary
Depends on the amount and location of damage to the CNS
Which types of immune cells are associated with inflammation in MS?
- Perivascular immune cell infiltration by CD3 T cells and CD20 B cells
What is encephalitis?
- Inflammation of the brain caused by infection or autoimmune mechanisms
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What is meningitis?
- Inflammation of the meninges caused by viral or bacterial infection
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What are the 4 main types of bacterial meningitis?
- Meningococcal
- Pneumococcal
- Haemophilus influenza type b (Hib)
- Streptococcal
Which bacteria is the most common cause of meningitis in the UK?
- Meningococcal
Which type of bacteria meningitis is most common in newborn babies?
- Streptococcal
What are the non-bacterial causes of meningitis?
- Viral
- Fungal
How is meningitis diagnosed?
- Lumbar puncture (Increased WBC count, Increased protein, Decreased sugar levels)
What is the contraindication of a lumbar puncture to diagnose meningitis?
-
Papilloedema (Optic disc swelling)
- If present it suggests an increased cranial pressure
- If a lumbar puncture takes place, leads to conning-pulling brainstem down
- If present it suggests an increased cranial pressure
How is meningitis managed (4)?
- Depending on cause: Antivirals, Antibiotics, Antifungals, Steroids
- Anti-convulsants
- Ventilation
- Analgesics