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Neuropathology of Injury

Neuropathology of Injury. Neuropathology of Injury protection expansion no lymphatics tight junctions tight junctions & astrocyte processes BBB. Neuropathology of Injury capillaries not fenestrated [except choroid plexus] end arterioles minimal interstitial space

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Neuropathology of Injury

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  1. Neuropathology of Injury

  2. Neuropathology of Injury • protection • expansion • no lymphatics • tight junctions • tight junctions & astrocyte processes BBB

  3. Neuropathology of Injury • capillaries not fenestrated [except choroid plexus] • end arterioles • minimal interstitial space • minimal perivascular space • minimal connective tissue [collagen and elastin]

  4. CNS TRAUMA Concussion:temporary loss of function - unconsciousness for brain paralysis for spinal cord

  5. CNS TRAUMA Contusion:disruption of architecture with haemorrhage at impact site or distant site

  6. CNS TRAUMA Laceration:severe and permanent disruption of tissues with haemorrhage and necrosis

  7. Haemorrhage

  8. Acute brain swelling and unregulated vasodilation

  9. Myelomalacia - necrosis or softening of spinal cord Type-1 disk protrusion Haemorrhagic myelomalacia

  10. RAISED INTRACRANIAL PRESSURE oedema haemorrhage abscess tumour generalised inflammation increased CSF production decreased CSF drainage generalised signs

  11. CEREBRAL AND SPINAL CORD OEDEMA Oedema = escape of fluids, or failure to recirculate Question:Which of the characteristics listed earlier would alter the production, removal and consequences of cerebral oedema?

  12. protection • expansion • no lymphatics • tight junctions • tight junctions & astrocyte processes BBB

  13. protection - p • expansion • no lymphatics • tight junctions • tight junctions & astrocyte processes BBB

  14. protection - p • expansion - c • no lymphatics • tight junctions • tight junctions & astrocyte processes BBB

  15. protection - p • expansion - c • no lymphatics - r • tight junctions • tight junctions & astrocyte processes BBB

  16. protection - p • expansion - c • no lymphatics - r • tight junctions – p & r • tight junctions & astrocyte processes BBB

  17. protection - p • expansion - c • no lymphatics - r • tight junctions – p & r • tight junctions & astrocyte processes BBB – p & r

  18. capillaries not fenestrated [except choroid plexus] • end arterioles • minimal interstitial space • minimal perivascular space • minimal connective tissue [collagen and elastin]

  19. capillaries not fenestrated – p & r [except choroid plexus] • end arterioles • minimal interstitial space • minimal perivascular space • minimal connective tissue [collagen and elastin]

  20. capillaries not fenestrated – p & r [except choroid plexus] • end arterioles - p • minimal interstitial space • minimal perivascular space • minimal connective tissue [collagen and elastin]

  21. capillaries not fenestrated – p & r [except choroid plexus] • end arterioles - p • minimal interstitial space - c • minimal perivascular space • minimal connective tissue [collagen and elastin]

  22. 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]

  23. 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]

  24. CEREBRAL AND SPINAL CORD OEDEMA Oedema = escape of fluids, or failure to recirculate • Vasogenic oedema • vessels • protein rich • astrocytes  i/s space • trauma, vascular, masses

  25. CEREBRAL AND SPINAL CORD OEDEMA Oedema = escape of fluids, or failure to recirculate • Cytotoxic oedema • glial cell swelling • protein free fluid • BBB intact • global • hypoxic, ischaemic, T/N/M, genetic

  26. BRAIN SWELLING ↑ tissue / fluid  2o fluid and pressure changes  fatal: * brain abscess in a calf * Coenurus cerebraliscyst 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

  27. Herniation of brain tissue right cerebral swelling  to left under falx cerebri pressure on thalamus

  28. Herniation of brain tissue right cerebral swelling  caudally under tentorium cerebelli pressure on midbrain

  29. Herniation of brain tissue further swelling  cerebellum through foramen magnum pressure on medulla oblongata

  30. VASCULAR AND CIRCULATORY LESIONS blood supply Brain - carotid and vertebral arteries, circle of Willis anastomoses pia-arachoid, then end arteries collateral supply poor

  31. VASCULAR AND CIRCULATORY LESIONS blood supply 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

  32. VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Vasculitis, eg EHV-1 arteritis in a horse

  33. VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Thrombo-embolisim, eg Salmonella septicaemia in pigs

  34. VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Hypoxia/ischaemia, eg neonatal seizures in a foal anaesthetic accident in a dog

  35. VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Coagulopathies, eg DIC in septic mastitis

  36. VASCULAR AND CIRCULATORY LESIONS Question: Why should grey matter be more susceptible than white mater to many vascular and circulatory insults?

  37. VASCULAR AND CIRCULATORY LESIONS Infarction

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