Neurology

Question 1

cerebritis

Answer 1

Nonencapsulated brain abscess

Question 2

Etiology

Answer 2

1. spread from contiguos site of infection (sinusitis, otitis, dental infection)
2. head trauma or neurosurgical procedure
3. hematogenous spread

Question 3

stages abscess formation

Answer 3

1. early cerebritis (1-3 days) central core of coagulative necrosis surrounded by perivascular infiltration of inflammatory cells. Marked edema surrounding
   2 late cerebritis (4-9 days) enlargement of necrotic centrar by formation of pus, inflammatory infiltrate of macrophages and fibroblasts.
   3 early capsule formation (10-13 days) capsule better developed in cortical side (not ventricular), ring enhacing capsule in imaging
   4 Late capsule formation (>14 days) necrotic center surrounded by dense collagenous capsule. Edema has regressed, gliosis wiith astrocytes outside capsule.

Question 4

clinical presentacion brain abscess

Answer 4

Headache: constant, dull, hemocranial or generalized, or progressively severe refractory to tx. (75%)
Focal neurological deficits (>60%)
Fever (50%)
Seizures (35%)