neuropathology of injury protection expansion no lymphatics tight junctions tight junctions...
TRANSCRIPT
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Neuropathology of Injury
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Neuropathology of Injury
protection expansion no lymphatics tight junctions tight junctions & astrocyte processes
BBB
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Neuropathology of Injury capillaries not fenestrated
[except choroid plexus] end arterioles minimal interstitial space minimal perivascular space minimal connective tissue
[collagen and elastin]
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CNS TRAUMA
Concussion: temporary loss of function - unconsciousness for brain paralysis for spinal cord
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CNS TRAUMA
Contusion: disruption of architecture with haemorrhage at impact site or distant site
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CNS TRAUMA
Laceration: severe and permanent disruption of tissues with haemorrhage and necrosis
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Haemorrhage
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Acute brain
swelling and
unregulated
vasodilation
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Myelomalacia - necrosis or softening of spinal cord
Type-1 disk protrusion Haemorrhagic myelomalacia
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RAISED INTRACRANIAL PRESSURE
oedema
haemorrhage
abscess
tumour
generalised inflammation
increased CSF production
decreased CSF drainage
generalised signs
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Question: Which of the characteristics listed earlier would alter the production,
removal and consequences of cerebral oedema?
Oedema = escape of fluids, or failure to recirculate
CEREBRAL AND SPINAL CORD OEDEMA
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protection
expansion
no lymphatics
tight junctions
tight junctions & astrocyte processes
BBB
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protection - p
expansion
no lymphatics
tight junctions
tight junctions & astrocyte processes
BBB
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protection - p
expansion - c
no lymphatics
tight junctions
tight junctions & astrocyte processes
BBB
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protection - p
expansion - c
no lymphatics - r
tight junctions
tight junctions & astrocyte processes
BBB
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protection - p
expansion - c
no lymphatics - r
tight junctions – p & r
tight junctions & astrocyte processes
BBB
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protection - p
expansion - c
no lymphatics - r
tight junctions – p & r
tight junctions & astrocyte processes
BBB – p & r
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capillaries not fenestrated
[except choroid plexus] end arterioles minimal interstitial space minimal perivascular space minimal connective tissue
[collagen and elastin]
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capillaries not fenestrated – p & r
[except choroid plexus] end arterioles minimal interstitial space minimal perivascular space minimal connective tissue
[collagen and elastin]
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capillaries not fenestrated – p & r
[except choroid plexus] end arterioles - p minimal interstitial space minimal perivascular space minimal connective tissue
[collagen and elastin]
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capillaries not fenestrated – p & r
[except choroid plexus] end arterioles - p minimal interstitial space - c minimal perivascular space minimal connective tissue
[collagen and elastin]
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capillaries not fenestrated – p & r
[except choroid plexus] end arterioles - p minimal interstitial space - c minimal perivascular space - c minimal connective tissue
[collagen and elastin]
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capillaries not fenestrated – p & r
[except choroid plexus] end arterioles - p minimal interstitial space - c minimal perivascular space - c minimal connective tissue - ?
[collagen and elastin]
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Oedema = escape of fluids, or failure to recirculate
CEREBRAL AND SPINAL CORD OEDEMA
Vasogenic oedema
• vessels
• protein rich
• astrocytes i/s space
• trauma, vascular, masses
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Oedema = escape of fluids, or failure to recirculate
CEREBRAL AND SPINAL CORD OEDEMA
Cytotoxic oedema
• glial cell swelling
• protein free fluid
• BBB intact
• global
• hypoxic, ischaemic, T/N/M, genetic
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BRAIN SWELLING
* brain abscess in a calf
* Coenurus cerebralis cyst forebrain of sheep
* astrocytoma, Boxer dog
* feline infectious peritonitis panencephalitis in a cat
* head trauma + cerebral oedema in a goat kid
* thiamin-responsive, cerebral cortical necrosis in a lamb
↑ tissue / fluid 2o fluid and pressure changes fatal:
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Herniation of brain tissue
right cerebral swelling to left under falx cerebri
pressure on thalamus
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Herniation of brain tissue
right cerebral swelling caudally under tentorium cerebelli
pressure on midbrain
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further swelling cerebellum through foramen magnum
Herniation of brain tissue
pressure on medulla oblongata
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VASCULAR AND CIRCULATORY LESIONS
blood supply
Brain - carotid and vertebral arteries, circle of Willis
anastomoses pia-arachoid, then end arteries
collateral supply poor
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Spinal cord - vertebral aa. (C), radicular aa. (T-L) ventral spinal a.
central grey matter-branches of ventral spinal a.
white matter - meningeal vs. via end arteries
VASCULAR AND CIRCULATORY LESIONS
blood supply
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Vascular and circulatory lesions from:-
VASCULAR AND CIRCULATORY LESIONS
Vasculitis, eg EHV-1 arteritis in a horse
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Vascular and circulatory lesions from:-
VASCULAR AND CIRCULATORY LESIONS
Thrombo-embolisim, eg Salmonella septicaemia in pigs
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Vascular and circulatory lesions from:-
VASCULAR AND CIRCULATORY LESIONS
Hypoxia/ischaemia, eg neonatal seizures in a foal anaesthetic accident in a
dog
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Vascular and circulatory lesions from:-
VASCULAR AND CIRCULATORY LESIONS
Coagulopathies, eg DIC in septic mastitis
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VASCULAR AND CIRCULATORY LESIONS
Question: Why should grey matter be more susceptible than white mater to many vascular and circulatory insults?
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VASCULAR AND CIRCULATORY LESIONS
Infarction
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