Post on 29-May-2018
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y Frequency and emergency condition
Pathogens
-Bacteria - Tuberculosis-Virus - Prion [CNS only]-Fungus - Parasite
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y Hematogenous spread : most common
Direct invasion : trauma, surgery
Adjacent area: sinus ,mastoid ,middle ear
Placenta : rubella ,toxoplasmosis
Peripheral nerve : rabies
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y , 1.
2. ,,
,,3.
4.
Polymerase chain reaction(PCR)
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y 3 y Dura matery Arachnoidy
Pia mater
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y Lepto meninges (pia + arachnoid)
y Coverbrain, spinal cord, proximalCranial nervesandPeripheral nerve
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y The blood-brain barrier (BBB) is a separation ofcirculating blood and cerebrospinal fluid (CSF)maintained by the choroid plexus in the central
nervous system(CNS).
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It is composed of endothelial cells, which are packed verytightly in brain capillaries
Tight junction
Astrocyte cell projections called astrocytic feet (also
known as "glial limitans") surround the endothelial cells ofthe BBB
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y Endothelial cell restrict the diffusion ofmicroscopic objects (e.g. bacteria) and large orhydrophillic molecules into the CSF, while allowingthe diffusion of small hydrophobic molecules (O
2,
hormones, CO2).
Cells of the barrier actively transport metabolic
products such as glucose across the barrier withspecific proteins.
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y This "barrier" results from the selectivity of the tightjunctions between endothelial cells in CNS vessels thatrestricts the passage of solutes.
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Blocking massive molecules >500 dalton
y Preventing toxins, viruses, and bacteria
y Preventing ATB enter CNS
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y Blood brain barrier1.small molecules
2.lipid soluble molecules
3.small protein binding
Meningeal inflammation (meningeal inflammation)
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1. ANATOMICAL BARRIER
Scalp, skull, dura, leptomeninges
Blood brain barrier and Blood CSF Barrier
2. IMMUNOLOGICALDEFENSEHumoral response, Phagocytic cellular response
and Complement-No WBC, onlymicloglia-Immunoglobulin and complement
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y GENERAL SYSTEMIC SYMPTOM
FOCAL NEUROLOGICALDEFICIT
AL
TE
RATI
ON OF CONCI
OUSNE
SS MININGISMUS:FEVER,STIFF NECK,PHOTOPHOBIA
FEVER
SEIZ
URE
PAIN,HEADACHE
SIGN OF INCREASEDINTRACRANIALPRESSURE :HEADACHE,BLURR VISION,VOMITING
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Thank you for attention
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