cerebral inflammation

Question 1

what is meningitis?

Answer 1

inflammation of the meninges caused by viral or bacterial infection

Question 2

what is encephalitis

Answer 2

inflammation of the BRAIN caused by infection OR AUTOIMMUNE mechanisms

Question 3

what is cerebral vasculitis

Answer 3

inflammation of blood vessel walls (angitis)

Question 4

why do dyes and ohher traces injected IV accumulate in most tissues but not in CNS?

Answer 4

due to blood brain barrier

Question 5

describe broadly the vascularisation of CNS and state a fact that illustrates this

Answer 5

dense, no neuron is more than 100μm from a capillary

Question 6

what makes the bbb?

Answer 6

most importantly the vascular morphology! Also glial cells

Question 7

what is the difference between other cappilaries and CNS cap that leads to bbb?

Answer 7

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

Question 8

what is the purpose of the BBB

Answer 8

TO HAVE GREATER CONTROL over what enters the cns circulation

blood borne infecitons have reduced entry to cns tissue

Question 9

what vessels do brain capillaries stem from?

Answer 9

Pial vessels

Question 10

how to the necessary substances go into CNS if the junctions are so tight in bbb?

Answer 10

though influx and efflux transporters: membrane transporters specific to each relevant substance

Question 11

what are astrocytes and what is their role in BBB

Answer 11

a specialized type of glial cell that is vital in the maintnance of the bbb integrity (astrocyte “endfeet” sitting tight to the vasculature)

Question 12

what are the 4 main mechanisms of pathophysiology in BBB disruption

Answer 12

1) fibrinogen leakage (from cappilaries to astrocytes)

2) astrogliosis (astrocytes become activated and undergo structural changes )

3) astrocytic end-feet change

4) collagenous disruption

Question 13

initial symptoms of encephalitis

Answer 13

flu-like with pyrexia (high body temperature) and headache

Question 14

sympotms of encephalitis as time goes by (within hours days or weeks )

Answer 14

-confusion or disorientation
-seizures or fits
-changes in personality and behaviour
-difficulty speaking
-weakness or loss of movement
-loss of consciousness

Question 15

most common cause of encephalitis and most common specific examples

Answer 15

viral infection,

Herpes Simplex
Measles
Varicella (chickenpox)
Rubella (German measles)

Question 16

other rarer causes of encephalitis

Answer 16

-Mosquito, tick and other insect bites

-Bacterial and fungal infections

-Trauma

-Autoimmune

Question 17

treatments of encephalitis?

Answer 17

depends onthe underlyingcause, but may include:

Antivirals e.g. acyclovir
Steroids. (swelling
Antibiotics/antifungals
Analgesics
Anti-convulsants
Ventilation

Question 18

what other new health crisis is associated with long term neurological deficits?

Answer 18

covid 19

Question 19

what is multiple sclerosis

Answer 19

autoimmune demyelinating disease of CNS

Question 20

what is the progression of MS in terms of the neurological deficits? (2 phases)

Answer 20

first phase usually “relapsing- remitting” nature

second progression: linear increase in neuro deficits

Question 21

what are the neuro deficit relapses caused by/ linked to?

Answer 21

inflammation

Question 22

what is the seconf phase neuro def progression linked to?

Answer 22

axonal loss and neurodegeneration

Question 23

4 terms that describe the cellular pathology of ms

Answer 23

Inflammation

Demyelination

Axonal loss

Neurodegeneration

Question 24

where is the brain damage mostly seen in MS brain scan

Answer 24

atound ventricles

Question 25

why do sympotms cary in ms?

Answer 25

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

Question 26

what happens during inflammaiton in ms

Answer 26

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

Question 27

how dangerous is meningitis death wise? how many people affected per year? how many with permanent impariment?

Answer 27

6th most common infectious disease killer
Affects more than 5 million people per annum worldwide
Leaves 1 in 5 of the infected people with an impairment

Question 28

bacterial causes of meningitis

Answer 28

Meningococcal
Pneumococcal
Haemophilus Influenzae type b (Hib)
Streptococcal –

Question 29

– the most common cause of bacterial meningitis in UK

Answer 29

meningococcal

Question 30

the main cause of meningtitis in new-born babies

Answer 30

streptococcal