CNS Inflammation - Pathology - Revision history

Bara: Redirected page to Category:Central Nervous System - Inflammatory Pathology

2011-03-08T12:55:28Z

Redirected page to Category:Central Nervous System - Inflammatory Pathology

Bara at 12:54, 8 March 2011

2011-03-08T12:54:34Z

Bara at 12:53, 8 March 2011

2011-03-08T12:53:39Z

Bara at 12:52, 8 March 2011

2011-03-08T12:52:31Z

Bara at 12:51, 8 March 2011

2011-03-08T12:51:50Z

Bara at 12:51, 8 March 2011

2011-03-08T12:51:29Z

Bara at 12:50, 8 March 2011

2011-03-08T12:50:06Z

Bara: /* Prion Diseases */

2010-07-01T11:01:54Z

Prion Diseases

Bara: /* Prion Diseases */

2010-07-01T11:01:39Z

Prion Diseases

Bara: /* Prion Diseases */

2010-07-01T10:59:59Z

Prion Diseases

← Older revision		Revision as of 12:55, 8 March 2011
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−	[[Central Nervous System ~~Inflammation Overview]]~~	+	#redirect[[:Category:Central Nervous System - Inflammatory Pathology]]
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−
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−	~~[[Central Nervous System Infectious Inflammation]]~~
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−
−
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−	~~==[[:Category:CNS Non~~-~~Infectious~~ Inflammatory ~~Diseases]]==~~
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−	~~===[[Granulomatous Meningoencephalitis]]===~~
−
−	~~[[Necrotising Meningoencephalitis~~]]

← Older revision		Revision as of 12:54, 8 March 2011
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	[[Necrotising Meningoencephalitis]]		[[Necrotising Meningoencephalitis]]
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−
−
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−	~~===Pug Encephalitis===~~
−
−	* A [[CNS Idiopathic Conditions - Pathology\|CNS idiopathic condition]]
−	* Affects pugs.
−	** Similar conditions are seen in yorkshire and maltese terriers.
−	* Officially known as necrotising meningoencephalitis of small dogs.
−	* Characterised by histological forebrain inflammation and necrosis.
−	* The disease is uniformly fatal.
−	** Corticosterid treatment has no effect.
−
−
−	~~[:Category:CNS Non-Infectious Inflammatory Diseases]]~~

← Older revision		Revision as of 12:53, 8 March 2011
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	===[[Granulomatous Meningoencephalitis]]===		===[[Granulomatous Meningoencephalitis]]===
−	~~(GME)~~
−	* An [[CNS Idiopathic Conditions - Pathology\|idiopathic CNS conditon]]
−	* May occur as:
−	** A disseminated disease
−	** A focal mass lesion
−	** A primary occular disease
−	* Brainstem signs are common, although the forebrain is primarily affected.
−	* May be incorrectly diagnosed as lymphoma.
−	* Changes are apparent in the CSF.
−	** There is usually a mononucloear pleocytosis.
−	** Sometimes only protein is elveated.
−	* Diffuse inflammatory changes or a mass lesion will be seen by advanced imaging.
−	** However, biopsy is required for a definative diagnosis.
−	* Life span is between 6 months and 1 year from diagnosis.

−	~~====Treatment====~~	+	[[Necrotising Meningoencephalitis]]

−	* Immunosuppression:
−	** Corticosteroids
−	** Azathioprine
−	** Cycophosphamide
−	* Surgery
−	** This is only appropriate if there is a focal mass.
−	* Radiation therapy.
−
−	~~[[Necrotising Meningoencephalitis]]~~

−	~~[[:Category:CNS Non-Infectious Inflammatory Diseases]]~~

← Older revision		Revision as of 12:52, 8 March 2011
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	[[Central Nervous System Infectious Inflammation]]		[[Central Nervous System Infectious Inflammation]]

−	~~==Routes of Entry==~~

−	* CNS inflammation is usually the result of infection.
−	** This may be caused by:
−	*** Bacteria
−	*** Fungi
−	*** Protozoa
−	*** Viruses
−	* Organisms must first enter the CNS in order to establish infection.
−	** There are several routes of entry that allow this:
−	**# '''Haematogenous entry'''
−	*# This is the most common route.
−	**# '''Entry via the peripheral nerves'''
−	*# Organisms track within the axoplasm of axons.
−	*# For example, ''Listeria monocytogenes''.
−	**# '''Penetrating trauma'''
−	*# For example, dehorning wounds, skull fracture or tail docking.
−	**# '''Direct spread of infection'''
−	*# From the nasal cavity, middle ear or paranasal sinuses.
−
−	~~==Localisation of Infectious Organisms==~~
−
−	* After entry, organisms may establish in one or more of four main areas:
−	*# '''Epidural space'''
−	# Infection tends to manifest as abscess formation.
−	*# '''Subdural space'''
−	# Manifests as abscess formation.
−	# Fairly uncommon.
−	*# '''Leptomeninges'''
−	# Causes leptomeningitis, which may be:
−	## Suppurative
−	##* The most common form.
−	##* Neutrophils are the predominant cell type.
−	##* Caused by bacteria
−	##** E.g. ''E. coli'' and ''Streptococcus''
−	##* There are often no gross lesions, but the brain may appear swollen and the meninges opaque.
−	##* Usually results in death.
−	## Eosinophilic meningoencephalitis
−	##* The classic example of this is porcine salt poisoning, when water has been restricted and the suddenly replenished.
−	##* Perivascular eosinophilic cuffing is seen in the cerebrum and meninges.
−	## Lymphocytic
−	##* Usually of viral origin.
−	## Granulomatous
−	##* Caused by fungal diseases and Mycobacteriosis.
−	*# '''CNS parenchyma'''
−
−	~~==Bacterial Infections==~~
−	~~[[Image:pneumococcalmeningitis.jpg\|thumb\|right\|150px\|Pneumococcal meningitis. Image courtesy of BioMed Archive]]~~
−	* Bacterial infections typically result in abscesses.
−	** These may be single or multiple depending on the route of entry, and vary in size.
−	** They contain a central, liquefied cavity.
−	* There are differences between cerebral abscesses and those occuring elsewhere.
−	** Encapsulation is slow.
−	*** This is due to a lack of fibroblasts.
−	*** There is therefore less collagen in the capsule.
−	** Astrocytic glial fibers are not as strong as collagen
−	* Other organisms may cause similar infections:
−	** Rickettsial organisms
−	*** E.g. ''Ehrlichia''
−	** Spirochates
−	*** E.g. Leptospirosis
−
−	~~==Viral Infections==~~
−
−	* Viral infections tend to reach the CNS by haematogenous spread and via peripheral nerves.
−	* There are three hallmark lesions of CNS viral infections:
−	*# Neuronal necrosis
−	*# Gliosis
−	*# Vascular changes
−	* Several types of virus may cause inflammation in the CNS. [[Image:negribodies.jpg\|thumb\|right\|150px\|Negri bodies, as seen in rabies. Image courtesy of BioMed Archive]]
−	** '''Neurotropic''', e.g.
−	*** Rabies (rhabdovirus)
−	*** Aujesky’s disease (herpesvirus)
−	*** Visna (ovine lentivirus)
−	** '''Endotheliotropic''', e.g.
−	*** Infectious canine hepatitis (canine adenovirus)
−	*** Classical swine fever (pestivirus)
−	*** Equine herpesvirus type 1 (herpes)
−	** '''Pantropic'''
−	*** Infectious canine distemper (morbillivirus)
−	*** Infectious bovine rhinotracheitis (bovine herpesvirus type 1)
−	* Other examples of viruses affecting the CNS:
−	** Distemper
−	** Parvovirus
−	** Parainfluenza
−	** Herpes
−	** FIP
−	** FIV
−	** FeLV
−	** Pseudorabies
−	** Rabies
−
−	~~==[[Prion Disease]]==~~
−
−
−	~~[[Category:Central Nervous System - Inflammatory Pathology]]~~

← Older revision		Revision as of 12:51, 8 March 2011
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	[[Central Nervous System Inflammation Overview]]		[[Central Nervous System Inflammation Overview]]

−	~~==Introduction==~~

−	* Although the CNS is well protected, its defences against organisms that have already invaded are less well developed. This is due to:
−	*# Minimal antibody production
−	*# Cerebrospinal fluid providing a good culture medium for invading organisms.
−	*# Inflammatory cell, antibody and drug entry to the CNS being impeded by the blood-brain barrier.
−
−	~~===Classification of Inflammation===~~
−
−	* CNS inflammation may manifest as encephalitis or meningitis.
−	** These often co-exist.
−	* The aetiology CNS inflammation may be:
−	** Infectious
−	*** Bacteria
−	*** Fungi
−	*** Protozoa
−	*** Viruses or non-infectious.
−	*** Infectious agents vary geographically.
−	** Non-infectious
−	*** No infectious cause can be found in 60% of meningitis cases.
−	* Inflammation may also be broadly classified based on the nature of the exudate present.
−	** '''Fibrinous'''
−	*** Caused by bacteria infection (including ''Mycoplasma'').
−	** '''Suppurative'''
−	*** Caused by bacteria and fungi.
−	** '''Granulomatous'''
−	*** Caused by bacteria or fungi.
−	** '''Lymphoplasmacytic'''
−	*** Caused by viruses.
−	** '''Haemorrhagic'''
−	*** This is rare.
−	*** Usually associated with septicemia or infarcts.
−
−	~~==Clinical Signs of CNS Inflammation==~~
−
−	* Signs often reflect multiple levels of neurological involvement.
−	* Generalised [[Forebrain Disease - Pathology#Clinical Signs\|forebrain signs]] are seen.
−	* Neck pain may be seen alone, or with other signs.
−
−	~~==Diagnosis==~~
−
−	* History, physical and neurological examination.
−	* Fundic examination may give clues as to whether a systemic infection is present.
−	* CSF examination may help define the problem.
−
−	~~==Treatment==~~
−
−	* Treatment is directed at a specific cause, if one can be found.
−	** If a cause cannot be found, trimethoprim, clindamycin or doxycycline plus or minus corticosteroids may be used.
−
−	~~[[Category:Central Nervous System - Inflammatory Pathology]]~~

	[[Central Nervous System Infectious Inflammation]]		[[Central Nervous System Infectious Inflammation]]

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 [[Necrotising Meningoencephalitis]]
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 * The disease is uniformly fatal.
 ** Corticosterid treatment has no effect.

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-{{review}}
+[[Central Nervous System Inflammation Overview]]
 ==Introduction==
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 *** This is rare.
 *** Usually associated with septicemia or infarcts.
 ==Routes of Entry==
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 ==[[Prion Disease]]==
-===Granulomatous Meningoencephalitis (GME)===
+[[Category:Central Nervous System - Inflammatory Pathology]]
 * An [[CNS Idiopathic Conditions - Pathology|idiopathic CNS conditon]]
 * May occur as:
@@ Line 163: / Line 180: @@
 ** This is only appropriate if there is a focal mass.
 * Radiation therapy.
 ===Pug Encephalitis===
@@ Line 173: / Line 193: @@
 * The disease is uniformly fatal.
 ** Corticosterid treatment has no effect.

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 ** Rabies
-==[[Prion Diseases]]==
+==[[Prion Disease]]==
 ==Non-Infectious Inflammatory Diseases==

← Older revision		Revision as of 10:59, 1 July 2010
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	==Prion Diseases==		==Prion Diseases==
−
−	* Prion diseases are also knowns as transmissible spongiform encephalopathies (TSEs).
−	* They are a group of fatal neurodegenerative diseases which occur in a number of species, including man.
−	** For example:
−	*** Bovine spongiform encephalopathy (BSE) in cattle
−	*** Scrapie in sheep
−	*** Chronic wasting disease in elk
−	*** Creutzfeldt-Jakob disease (CJD), Gerstmann-Sträussler-Scheinker disease (GSS), fatal familial insomnia (FFI) and kuru in man
−	* TSEs have a long incubation period, making them difficult to diagnose.
−
−	~~===Aetiology===~~
−
−	* The aetiology of prion diseases is still highly controversial.
−	** However, an abnormal isoform of the host-encoded prion protein (PrP) is seen in the brains of affected animals.
−	*** The normal host PrP changes its structure into the disease-associated form PrPSc.
−	** The abnormal proteint (PrPSc) accumulates as amyloid fibrils in nervous tissue.
−	* The agent appears to be highly resistant.
−
−	~~===Pathology===~~
−
−	~~====Gross====~~
−
−	* Prion diseases cause NO GROSS LESIONS.
−
−	~~====Hisological====~~
−
−	* TSEs typically cause what is known as the "microscopic triad":
−	*# Spongiform change.
−	# Vacuolation of neurons.
−	# Particularly in nuclei.
−	*# Astrogliosis
−	*# Amyloid plaques
−	# These are not always seen.

	==Non-Infectious Inflammatory Diseases==		==Non-Infectious Inflammatory Diseases==