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Year 2 Neuro > Cerebral Inflammation > Flashcards

Cerebral Inflammation 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 (sometimes called angiitis)

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4
Q

How was the Blood Brain Barrier discovered?

A

Discovered that dyes injected intravenously will accumulate in most tissues but no the brain

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5
Q

How do we know the brain is rich in blood supply?

A

Dense vascularisation of the brain - No neuron is more than 100µm from a capillary

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6
Q

How does the BBB reduce fluid leak?

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 tightness of the BBB allow for?

A

solutes that can exchange across peripheral capillaries cannot cross the BBB

allows the BBB to control the exchange of these substances using specific membrane transporters to transport into and out of the CNS

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8
Q

Why is the BBB important?

A

Blood-borne infectious agents have reduced entry into CNS tissue

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9
Q

What happens when the endothelial layer of the BBB becomes disrupted after trauma?

A

Contents of the blood can move into brain

e.g. fibrinogen is seen in brain blood vessels after trauma

Glial cells react and astrocytes retract and break down BBB

Basement menbrane change and collagen builds up - possible sclerosis for vessels

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10
Q

What are initial symptoms of encephalitis?

A

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

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11
Q

What are the subsequent symptoms of encephalitis?

A 
confusion or disorientation
seizures or fits
changes in personality and behaviour
difficulty speaking
weakness or loss of movement
loss of consciousness
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12
Q

What are the most common causes of encephalitis?

A

Viral infections

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

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13
Q

What are other causes of encephalitis?

A

Mosquito, tick and other insect bites
Bacterial and fungal infections
Trauma
Autoimmune

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14
Q

How do we treat encephalitis?

A 
Antivirals e.g. acyclovir
Steroids
Antibiotics/antifungals
Analgesics
Anti-convulsants
Ventilation
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15
Q

What does treatment of encephalitis depend on?

A

The underlying cause

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16
Q

What is Multiple Sclerosis?

A

Autoimmune attach on the BBB
Demyelinating disease
Relapsing - remitting episodes (due to inflammatory activity)
Deficits increase over time due to axonal loss

17
Q

What is the cellular pathology of MS?

A

Inflammation

Demyelination

Axonal loss

Neurodegeneration

18
Q

Why do symptoms of MS vary so much?

A

Random disorder that can occur in the white matter anywhere in the brain

Amount and location of the damage varies so much

19
Q

What is characteristic of inflammation in MS?

A

Perivascular cuffing - infiltration of immune cells into the substance of the brain

Form cuff around vessels

Largely T-cells but also B-cells

20
Q

What are the main features of Meningitis?

A

Irritation, inflammation and swelling of the meninges
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

21
Q

What are the causes of Meningitis?

A

Bacterial

Meningococcal – the most common cause of bacterial meningitis in UK
Pneumococcal
Haemophilus Influenzae type b (Hib)
Streptococccal – the main cause in newborn babies

22
Q

What are the other causes of Meningitis?

A

Viral - very rarely life-threatening

Fungal

23
Q

Who is more vulnerable to Meningitis?

A

Children
University students (people mixing with each other)
Eldery
Immunocompromised

24
Q

What is an infection of the spinal cord known as?

A

Vertebral osteomyelitis

25
Q

What are the symptoms of Meningitis?

A 
high temperature
cold hands and feet
nausea + vomiting
confusion
breathing quickly
muscle and joint pain
pale, mottled or blotchy skin
spots or a rash
headache
a stiff neck (nuchal rigidity)
a dislike of bright lights
being very sleepy or difficult to wake
fits (seizures)
26
Q

What diagnostic methods can diagnose meningitis?

A

Blood tests
Lumbar puncture
CT Scan

27
Q

What methods can diagnose encephalitis?

A

CT Scan
MRI Scan
EEG
Lumbar punctures

28
Q

What are the main complications with Meningitis?

A

hearing loss

visual impairments

problems with memory and concentration

cognitive decline

co-ordination, movement and balance problems
learning difficulties and behavioural problems
vision loss, which may be partial or total

loss of limbs – amputation is sometimes necessary to stop the infection

bone and joint problems, such as arthritis

kidney problems

29
Q

How might someone with encephalitis present differently to someone with meningitis?

A

Behavioural changes

Seizures

30
Q

How might someone with meningitis present differently to someone with encephalitis?

A

Neck stiffness

31
Q

How do you tell if someone has had a seizure if you haven’t observed it?

A

EEG
Electroencephalogram
Measure electrical activity of brain
Tell you that normal brainwaves are interrupted by abnormal brain waves

32
Q

Where is the epidural space found?

A

Spinal Cord

33
Q

Where is the site of lumbar puncture?

A

Below L2 vertebrae

34
Q

What does the lumbar puncture needle go through before reaching fluid?

A

Dura

Arachnoid

35
Q

What does CSF look like normally?

A

Watery and clear

36
Q

What is the significance of low glucose in CSF?

A

Confirm brain is infected

Low blood glucose is a hallmark of infection

37
Q

What structures would look different in severe meningitis?

A

Large ventricles
due to blockage of aqueduct
(hydrocephalus)

38
Q

What happens if you do a lumbar puncture in someone with raise intra-cranial pressure?

A

Herniation through foramen magnum

Must rule our raised intracranial pressure before lumbar puncture

Year 2 Neuro (15 decks)

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