cerebral inflammation

Question 1

what is meningitis?

Answer 1

inflammation of the meninges caused by viral/bacterial infection (bacterial more aggressive)

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 - sometimes called angiitis

Question 4

what is the maximum distance of a neuron from a capillary?

Answer 4

100um

- CNS is densely vascularised

Question 5

what forms the blood-brain barrier?

Answer 5

the capillaries

• tight junctions at endothelial cell-cell contacts
• > massively reduces passive movement of solute and fluid leak across the capillary wall

Question 6

what does the ‘tightness’ of the BBB capillaries prevent?

Answer 6

• crossing of solutes that can be exchanged across peripheral capillaries
• > BBB control exchange of these substances using specific membrane transporters to transport into and out of the CNS
• blood bourne infectious agents have reduced entry into CNS tissue

Question 7

what can cause BBB to become faulty (structural issue)?

Answer 7

• collagenous disruption

Question 8

what can you see in CNS near damaged blood vessels due to trauma?

Answer 8

• fibrinogen

Question 9

symptoms of encephalitis (7)

Answer 9

- flu-like with pyrexia and headache
see the following subsequently (hours/days/weeks)
- confusion or disorientation
- seizures/fits
- changes in personality and behaviour
- difficulty speaking
- weakness/loss of movement
- loss of consciousness

Question 10

is encephalitis more commonly caused by viruses or bacteria?

Answer 10

viruses

Question 11

viruses that commonly cause encephalitis (4)

Answer 11

• herpes simplex
• measles
• varicella
• rubella

Head suffering
Made
Very
Real

Question 12

other causes (non-viral) of encephalitis (4)

Answer 12

• mosquito, tick and other insect bites
• bacterial and fungal infections
• trauma
• autoimmune

Question 13

treatment of encephalitis does vary depending on underlying cause, but may include:
(6)

Answer 13

• antivirals e.g. acylclovir
• steroids
• ABs
• analgesics
• Anti-covulsants
• Ventilation

Question 14

example of an autoimmune disease that cause encephalitis?

Answer 14

• multiple sclerosis
• it’s a demyelinating disease of the CNS
• relapses linked to inflammatory activity
• progression linked to neurodegeneration

Question 15

what is the longstanding secondary progression of MS with no remissions attributed to?

Answer 15

axon loss

- the longer you have the disease, the more axon loss, the more residual deficits

Question 16

what do the relapse and remission phase of MS mirror?

Answer 16

the inflammatory process

Question 17

Cellular pathology of multiple sclerosis (4)
Involves
D\_\_\_\_
And
N\_\_\_

Answer 17

• inflammation
• demyelination
• axonal loss
• neurodegeneration

Question 18

multiple sclerosis symptoms vary with what?

Answer 18

the location and amount of damage to the nervous system

Question 19

immune cells that invade with MS inflammation?

Answer 19

CD3 T cells

CD20 B cells

Question 20

bacterial causes of meningitis (4)

Answer 20

MePneHaeStre

• meningococcal
• pneumococcal
• haemophilus influenzae type b
• streptococcal

Question 21

other causes of meningitis (2)

Answer 21

• viral (the very rare and life threatening ones; generally viral infections aren’t dangerous in meningitis unlike bacterial infection)
• fungal

Question 22

What space that surrounds pial vessels (in pia arachnoid)?

Answer 22

Virchow-robin space

Question 23

What is the membrane of a pial vessel called?

Answer 23

Glia limitans membrane

Question 24

What cells define the BBB?

Answer 24

Astrocytes- structural role

Question 25

What do astrocytes do following a rupture of the bbb?

Answer 25

Try to stop bleeding through astrogliosis

Question 26

Whats the difference between encephalitis and the flu?

Answer 26

With the flu, temperature goes down and symptoms resolve but with encephalitis, no resolution

Question 27

How do we treat bacterial meningitis?

Answer 27

IV ABs