1. Anatomy
    2. 1. Spinal cord
    2. Brain stem
    3. Diencephalon Interbrain
    4. Thalamus
    5. Hypothalamus
    6. Cerebellum Little brain
    7. Cerebrum
    8. Internal capsule
    9. Corpus callosum
    10. Sulci and gyri of the cerebrum
    11. Blood supply of brain
    12. Meninges of the brain
    13. Ventricular system and CSF flow
    14. Cranial nerves
    15. Eye
    16. Pharyngeal arches or Branchial arches
    17. Ear
  2. Physiology
    3. 18. Introduction of nervous system
    19. Synapse
    20. Signal transmission
    21. Effects of Drugs on ANS
    22. Motor system and Neuromuscular junction
    23. Reflexes
    24. Sensory system
    25. Maintenance of posture and Reticular formation
    26. Reticular formation
    27. Sleep
    28. Brain
    29. Thalamus
    30. Prefrontal cortex
    31. Higher cortical functions
    32. Speech and Language
    33. Hypothalamus
    34. Cerebellum
    35. Basal ganglia
    36. Limbic system
    37. Eye
    38. Ear
    39. Olfactory system
    40. Gustatory system
  3. Pathology
    4. 41. Meningitis
    42. Encephalitis
    43. Hydrocephalus
    44. Cerebro vascular disease or Stroke
    45. Tumors of CNS
    46. Astrocytoma
    47. Ependymoma
    48. Medulloblastoma
    49. Meningioma
    50. Neurofibroma
    51. Eye
    52. Retinoblastoma
    53. Ear, nose and throat
  4. Pharmacology
    5. 54. Introduction to autonomic pharmacology
    55. Cholinergic drugs
    56. Anti-cholinergic drugs
    57. Adrenergic drugs
    58. Anti-adrenergic drugs
    59. Drugs used in Glaucoma
    60. Drugs used in the treatment of pain
    61. Alcohols
    62. Sedative Hypnotics
    63. Antipsychotics
    64. Antianxiety drugs
    65. Antidepressants
    66. Analeptic agents
    67. Local anaesthetics
    68. General anaesthetics
    69. Anti-parkinsonial drugs
    70. Drugs used to reduce appetite or In the treatment of obesity
    71. Drugs for eye diseases
  5. Microbiology
    6. 72. Neisseria meningitidis
    73. Polio virus
    74. Rabies virus
    75. Japanese B Encephalitis Virus
    76. Laboratory Diagnosis of Meningitis
  6. Biochemistry
    7. 77. Introduction
    78. Acetylcholine neurotransmission steps
    79. Snake venom
    80. Neurotransmitters
Pathology
41. Meningitis
DEFINITION
Meningitis is the inflammatory process of leptomeninges and CSF within subarachnoid space.
IMAGE
    ◉ data:
    ◈ attributes:
    ■ url: https://upload.wikimedia.org/wikipedia/commons/thumb/5/54/Neck_stiffness.jpg/1920px-Neck_stiffness.jpg
    ■ caption: Neck stiffness
ROUTES_OF_SPREAD_OF_INFECTION
  1. Hematogenous route (Most common)
  2. Direct implantation
    3. ◉ example: Traumatic
  3. Local extension form infected adjacent structures like
    1. Sinuses
    2. Teeth
    3. Skull
    4. Vertebrae
  4. Via peripheral nervous system as with Rabies and Herpes Zoster Virus
TYPES
acute_pyogenic_meningitis
causative_agents
neonates
  1. E. coli and
  2. Group B Streptococcus
adolescents_and_young_adults
Neisseria meningitidis
elderly
Streptococcus pneumonia
morphology
gross
CSF
Cloudy or Frankly purulent
exudate
Present within Leptomeninges and ,b>Over the brain
vessel
Meningeal vessels are engorged
leptomeningeal_fibrosis
hydrocephalus
chronic_adhesive_arachnoiditis
Produced in case of Pneumococcal meningitis
microscopic
neutrophils
sub_acute_case
Leptomeningeal vessels
acute_case
Subarachnoid space
ventriculitis
In fulminant cases, infection may extend to ventricles producing ventriculitis.
phlebitis
  1. Venous thrombosis
  2. Hemorrhagic infarction of underlying brain.
CSF_findings
CSF_glucose
Markedly reduced
CSF_protein
Markedly raised
CSF_pressure
About 180 mm of water (Elevated)
lymphocyte_count
100-10000/μl
image
    ⟣ data:
    ➢ attributes:
    ⬦ url: https://upload.wikimedia.org/wikipedia/commons/1/1d/MenigitisCSF2019.jpg
    ⬦ caption: Cloudy CSF from a person with meningitis due to Streptococcus
signs_and_symptoms
  1. Meningeal irritability
  2. Morning heachache
  3. Photophobia
  4. Neck stiffness
  5. Clouding of consciousness
complications
  1. Chronic adhesive arachnoiditis
  2. Leptomeningeal fibrosis and hydrocephalus
  3. Phlebitis and hemorrhagic infarction of brain
  4. Ventriculitis
  5. Focal cerebritis and Cerebral abscess
viral_meningitis
other_name
Aseptic meningitis
causative_agents
  1. Enterovirus (Most common)
  2. Echovirus
  3. Mumps virus
  4. Coxsackie virus
  5. Epstein-Barr virus
  6. HSV-II
morphology
gross
some_cases
Swelling of brain
microscopic
Lymphocytic infiltration of leptomeninges
signs_and_symptoms
  1. Same as bacterial meningitis.
  2. Onset is acute and usually has benign self-limiting course.
CSF_findings
CSF_glucose
Normal
CSF_protein
Normal or mildly raised
CSF_pressure
Above 250 mm of water
lymphocyte_count
10-100/μl
bacterioloogically
Sterile
tuberculous_meningitis
causative_agents
morphology
gross
sub_arachonid_space
Thick exudate particullarly abundant in sulci and base of brain.
tubercle
1-2 mm diameter may be visible adjacent to blood vessel.
microscopic
inflammatory_cells
Acute or chronic inflammatory cells are found.
image
    ⟣ data:
    ➢ attributes:
    ⬦ url: https://upload.wikimedia.org/wikipedia/commons/thumb/f/f9/Meningitis_Histopathology.jpg/1920px-Meningitis_Histopathology.jpg
    ⬦ caption: Histopathology of bacterial meningitis: autopsy case of a person with pneumococcal meningitis showing inflammatory infiltrates of the pia mater consisting of neutrophil granulocytes
granuloma
May or may not contain Giant cell and Caseous necrosis
acid_fast_bacilli
Present
signs_and_symptoms
  1. Headache
  2. Confusion
  3. Vomiting
  4. Malaise
CSF_findings
CSF_glucose
Decreased
CSF_protein
Increased
CSF_pressure
Above 300 mm of water
lymphocyte_count
10-100/μl
bacterioloogically
Acid fast bacilli
tuberculoma
definition
Tuberculoma is a form of manifestation of tuberculous meningitis/brain TB.
gross
intraparenchymal_mass
  1. Well-circumscribed
  2. Single of multiple
  3. Several cm in daimeter --> Mass effect
microscopic
caseous_necrosis
location
Central-core
surrounded_by
Typical tuberculous granulomatous reaction
inactive_lession
Show calcification