1065776
Description
Mind Map by LewisLewis, updated more than 1 year ago
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Created by LewisLewis
almost 11 years ago
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Brain infective, demyelinating
and degenerative diseases
- INFECTIVE DISEASES
- Meningitis
- Acute pyogenic meningitis
- Bacterial (TB, spirochetal) or fungal disease
(cryptococcal); CSF is slightly cloudy with very few cells
- Bacterial (TB, spirochetal) or fungal disease
(cryptococcal); CSF is slightly cloudy with very few cells
- Aseptic meningitis
- Usually acute viral meningitis; the CSF is clear
- Usually acute viral meningitis; the CSF is clear
- Chronic meningitis
- Usually bacterial meningitis: in this case the CSF is purulent
- Usually bacterial meningitis: in this case the CSF is purulent
- Acute meningitis
- Most common pathogens
- E.Coli
- Haemophilus influenzae
- Streptococcus pneumoniae
- Neisseria meningitidis
- E.Coli
- Bacterial infections mechanisms:
- Hematogenous
- The most frequent
- The most frequent
- Post-traumatic
- Retrograde (from peripheral nerves)
- Local extension
- Hematogenous
- Clinical manifestations
- Signs of systemic infection
- Meningeal irritation and neurological involvement
- Headache
- Photophobia
- Clouding of consciousness
- Neck stiffness
- Headache
- Signs of systemic infection
- Spinal tap can give us very rapid and useful info
- Cloudy or frankly purulent CSF
- High number of neutrophils
- Increased protein concentration
- Reduced glucose content
- Cloudy or frankly purulent CSF
- Most common pathogens
- Bacterial
- Tuberculous meningitis
- Diagnosis is difficult
- Presentation
- CSF
- Modest pleocytosis with mononuclear and some PMN cells
- High protein concentration
- Glucose is only moderately reduced or normal
- Modest pleocytosis with mononuclear and some PMN cells
- MRI
- Location around the base of the brain
and along the ventricular system
- Location around the base of the brain
and along the ventricular system
- Presentation
- Complications
- Hydrocephalus
- Tuberculoma (rare)
- Hydrocephalus
- Ddx with sarcoidosis
- Diagnosis is difficult
- Neurosyphilis
- Borrheliosis (Lyme disease)
- Tuberculous meningitis
- Mycotic
- Aspergillus
- It can frequently invade the wall of vessels
- It can lead to necrotic abscess
- It can frequently invade the wall of vessels
- Crytptococcus
- Mainly in immunosuppressed patients
- Mainly in immunosuppressed patients
- Aspergillus
- Protozoan
- Toxoplasma
- Common in HIV patients especially before
introduction of anti-retroviral therapy
- Common in HIV patients especially before
introduction of anti-retroviral therapy
- Toxoplasma
- Diagnosis
- Physical exam
- Photophobia
- Brudzinski’s sign
- Lasegue straight leg test
- Nuchal rigidity
- Diffuse myalgia
- Vomit
- Photophobia
- Hemocolture
- Lumbar puncture
- Hemogas analysis
- Physical exam
- Acute pyogenic meningitis
- Meningoencephalitis
- Encephalitis
- Viral encephalitis
- Mainly a parenchymal infection usually
associated with meningeal inflammation
- Causes
- Coxsackie B
- Arbovirus
- Most frequent cause of viral enchepalitis,
especially in tropical areas
- West Nile
- Tick born virus (the most
frequent in Europe)
- Most frequent cause of viral enchepalitis,
especially in tropical areas
- Herpes virus
- Relatively common in children and young adults
- Tropism mainly for the temporal region
- Antiviral agents provide effective treatment
- Relatively common in children and young adults
- CMV
- JC virus
- It frequently affects immunosuppressed
people (HIV and post-transplant)
- It frequently affects immunosuppressed
people (HIV and post-transplant)
- HIV
- Rabies
- No vaccination
- Retrograde diffusion, it affects mainly motorneurons
- No vaccination
- Coxsackie B
- Mainly a parenchymal infection usually
associated with meningeal inflammation
- Viral encephalitis
- Damage to brain tissue derives from:
- Direct action of infectious agents
- Indirect action by secretion of toxins by bacteria
- Tissue damage due to inflammatory response
and immune mediated mechanisms
- Direct action of infectious agents
- Brain abscess
- Quite rare now
- It is a destructive lesion (contrarily to bacterial meningitis)
- Ddx both clinically and radiologically is with a tumor
- Streptococcus and Staphylococcus are the most commonly isolated organisms
- Quite rare now
- Meningitis
- DEGENERATIVE DISEASES
- Parkinson's disease
- Macroscopic aspect
- Substantia nigra and locus coeruleus are pale
- Substantia nigra and locus coeruleus are pale
- Microscopic aspect
- Catecholaminergic neurons
- Reactive glisosis
- Lewy bodies
- Cytoplasmic eosinophilic inclusions composed of aggregates of alpha-synuclein
- Cytoplasmic eosinophilic inclusions composed of aggregates of alpha-synuclein
- Catecholaminergic neurons
- Alteration of the nigro-striatal dopaminergic system
- Macroscopic aspect
- Alzheimer's disease
- Macroscopic aspects
- Atrophy of the cerebral cortex, especially in
frontal, temporal and parietal areas (not occipital)
- Ventricular dilation secondary to atrophy (ex-vacuo)
- Atrophy of the cerebral cortex, especially in
frontal, temporal and parietal areas (not occipital)
- Microscopic features
- Neuritis (senile) plaques
- Neurofibrillary tangles
- Progressive loss of neurons
- Reactive gliosis
- Neuritis (senile) plaques
- Macroscopic aspects
- Huntington's disease
- Neuronal degeneration in the striatum complex
- Initially patients are hyperkinetic and then evolve in
a Parkinson-like state with hypokineasia and rigidity
- Neuronal degeneration in the striatum complex
- Parkinson's disease
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