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brs (phase 1b) > (neuro) cerebral inflammation > Flashcards

(neuro) cerebral inflammation Flashcards

1
Q

define meningitis

A

inflammation of the meninges caused by a bacterial or viral infection

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2
Q

define encephalitis

A

inflammation of the brain caused by infection or autoimmune mechanisms

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3
Q

define cerebral vasculitis

A

inflammation of the blood vessel walls, involving the brain (alternatively called angiitis)

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4
Q

which is more aggressive in terms of meningitis: a bacterial or viral infection?

A

bacterial infection of the meninges tends to be more aggressive than a viral one

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5
Q

define myelitis

A

inflammation of the spinal cord

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6
Q

what is an alternative term for cerebral vasculitis?

A

angiitis

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7
Q

what is angiitis?

A

cerebral vasculitis (i.e. inflammation of the walls of small blood vessels)

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8
Q

how was the existence of the blood-brain barrier discovered?

A

dyes/tracers were injected intravenously into various tissues

accumulated in most tissues, except CNS tissues

= suggested the existence of a BBB

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9
Q

describe the vascularisation of the CNS

A

the CNS has very dense vascularisation as no neurone is more than 100 micrometres away from a capillary

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10
Q

how dense is the vascularisation of the CNS?

A

very dense - no neurone is ever more than 100 micrometres away from a capillary

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11
Q

how much of the cardiac output is directed towards the brain?

A

approximately 20%

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12
Q

how is the blood-brain barrier formed?

A

capillaries of the BBB have very strong tight junctions between the endothelial cells = massively reducing the solute and fluid leak across the capillary wall

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13
Q

why does the BBB actually work?

A

there are very strong tight junctions between the endothelial cells that massively reduce fluid and solute leakage across the capillary wall

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14
Q

how does diffusion occur across the endothelial tight junctions of the BBB?

A

nothing can freely diffuse across as the tight junctions are extremely strong = massively reduce the solute and fluid leakage across the capillary wall

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15
Q

which CNS cell is involved in maintaining the BBB?

A

astrocytes

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16
Q

how does the ‘tightness’ of the BBB capillaries compare to peripheral capillaries?

A

solutes that would normally diffuse and be exchanged across peripheral capillaries cannot cross the BBB

= special transporters to control the influx and efflux of these solutes into/out of the CNS

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17
Q

how is the brain adapted to overcome the additional ‘tightness’ caused by the BBB?

A

= special transporters to control the influx and efflux of these solutes into/out of the CNS (that cannot diffuse normally across the capillary wall)

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18
Q

give one way in which the tightness of the BBB is an advantage

A

blood-borne infectious agents have reduced entry into the CNS tissue

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19
Q

what are the initial symptoms of encephalitis?

A

initially

  • pyrexia (high body temperature)
  • headache
  • flu-like symptoms
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20
Q

what are the longer-term symptoms of encephalitis?

A

within hours, days, weeks

  • confusion, disorientation
  • seizures/fits
  • changes in personality/behaviour
  • difficulty speaking
  • weakness/loss of movement
  • loss of consciousness
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21
Q

what is the most common cause of encephalitis?

A

viral infection (herpes simplex, measles, varicella - chickenpox, Rubella)

22
Q

which viruses commonly cause encephalitis?

A

herpes simplex, measles, varicella (chickenpox), Rubella

23
Q

what are the possible causes of encephalitis?

A

viral infection

mosquite/tick/insect bites

bacterial/fungal infection

trauma

autoimmune

24
Q

what are the treatments for encephalitis?

A

depend on underlying cause BUT

  • antivirals
  • steroids
  • antibiotics/antifungals
  • analgesics
  • anticonvulsants
  • ventilation
25
Q

why are anti-convulsants used as treatment for encephalitis?

A

prophylactic treatment for potential seizures

26
Q

what is multiple sclerosis?

A

autoimmune demyelinating disease of the CNS

27
Q

how does multiple sclerosis occur?

A

autoimmune antibodies are produced against the myelin that encases the neurones of the CNS = causing demyelination and subsequent neurodegeneration

28
Q

what are the types of multiple sclerosis?

A

relapsing-remitting (associated w inflammation)

secondary progression

29
Q

what is the relapsing-remitting type of multiple sclerosis associated with?

A

inflammation (i.e. inflammatory demyelination)

30
Q

why is myelin important?

A

insulation of the neurones of the CNS and to enable saltatory conduction

31
Q

how does multiple sclerosis initially present?

A

initially presents with different neurological presentation each time

32
Q

how does axonal loss progress with multiple sclerosis?

A

progressively worsens as MS proceeds from being relapsing-remitting to continuous (secondary progression)

33
Q

what does axonal loss cause?

A

neurodegeneration

34
Q

how does the cellular pathology of multiple sclerosis progress?

A

inflammation
demyelination
axonal loss
neurodegeneration

35
Q

why do the symptoms vary so much between MS patients?

A

vary because the amount and location of damage/demyelination to the CNS is different in each person w MS

36
Q

what causes the progression of disease in multiple sclerosis and why?

A

increased inflammation

leads to increased demyelination = increased neurodegeneration

37
Q

how many people does meningitis affect yearly?

A

approx 5 million worldwide

38
Q

what is the long-term impact of meningitis on individuals?

A

leaves 1 in 5 people with an impairment after the infection has been cleared

39
Q

what are the main causes of meningitis?

A

bacterial infection (meningococcal, pneumococcal, haemophilus influnzae type B, streptococcal)

viral infection (very rarely life-threatening)

fungal infection

40
Q

what are the main causes of bacterial meningitis?

A

meningococcal (most common cause of bacterial meningitis in the UK)

penumococcal

HiB (haemophilus influenzae type B)

streptococcal (main cause in new born babies)

41
Q

what is the most common cause of bacterial meningitis in the UK?

A

meningococcal

42
Q

what is the most common cause of bacterial meningitis in the newborns?

A

streptococcal

43
Q

how is meningitis confirmed?

A

take a small sample of CSF and stain it to check for the presence of pathogens
(LUMBAR PUNCTURE)

44
Q

how do desired fluid and solute molecules overcome the blood-brain barrier?

A

active transport mechanisms (transport pumps)

45
Q

what are multiple sclerosis relapses associated with?

A

inflammatory (demyelination) activity

46
Q

what do immune cell infiltrates contain in multiple sclerosis?

A

both T lymphocytes and B lymphocytes

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

47
Q

what happens when the blood-brain barrier is disrupted?

A

leakage of blood from the capillary into the cerebral tissue

= astrocytes migrate to clean up and respond to the leakage

48
Q

what is the response to a blood-brain barrier disruption?

A

astrocytes migrate to clean up and respond to the leakage

49
Q

which cells respond to a blood-brain barrier disruption?

A

astrocytes

50
Q

what is astrogliosis?

A

when the astrocyte numbers increase significantly to repair damage to the CNS

(i.e. when BBB is damaged due to trauma/infection)

51
Q

which cells make up the perivascular immune cell infiltrate in multiple sclerosis?

A

CD3 T cells
CD20 B cells

= activated and then migrate across the BBB capillary walls to cause inflammation & damage

brs (phase 1b) (71 decks)

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