Neurological infection

2018 ◽  
Author(s):  
Tom Solomon ◽  
Benedict Michael
Keyword(s):  
Jc Virus ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Progressive Multifocal Leucoencephalopathy ◽  
Appropriate Treatment ◽  
General Physicians ◽  
Neurological Infections ◽  
The Brain ◽  
Neurological Infection ◽  
Csf Findings

Neurological infections can be broadly subdivided into chronic/subacute and acute. Chronic/subacute infection usually presents with global cognitive decline, with the prototypical disease being progressive multifocal leucoencephalopathy due to infection with the JC virus in immunocompromised patients. Acute neurological infections can be defined microbiologically, by the nature of the pathogen; clinically, by the presenting signs and symptoms and initial CSF findings; or anatomically. The anatomical definitions are those occurring intracranially (‘meningitis’, where infection involves the meninges overlying the brain; ‘encephalitis’, where the brain parenchyma is involved; or ‘cerebral abscesses’) and those affecting the spinal cord (‘myelitis’). However, there is often both clinical and histological overlap between these syndromes; consequently, the terms ‘meningoencephalitis’ and ‘encephalomyelitis’ are often used. Patients with acute intracranial CNS infections provide the greatest challenge to general physicians, because urgent investigation and appropriate treatment can save lives; they therefore form the focus of this chapter.

Lyme Disease: Acute Focal Meningoencephalitis in a Child

PEDIATRICS ◽  
1988 ◽  
Vol 82 (6) ◽  
pp. 931-934
Author(s):  
HENRY M. FEDER ◽  
EDWIN L. ZALNERAITIS ◽  
LOUIS REIK
Keyword(s):  
Nervous System ◽  
Case Report ◽  
Lyme Disease ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Tick Bite ◽  
System Involvement ◽  
History Of ◽  
Csf Pleocytosis ◽  
The Brain

Nervous system involvement in Lyme disease was originally described as meningitis, cranial neuritis, and radiculoneuritis,1-3 but Lyme disease can also involve the brain parenchyma. We describe a child whose first manifestation of Lyme disease was an acute, focal meningoencephalitis with signs and symptoms such as fever, headache, slurred speech, hemiparesis, seizure, and CSF pleocytosis. CASE REPORT A 7-year-old boy was hospitalized Aug 27, 1985, because of hemiparesis. Six weeks prior to admission he had vacationed at Old Lyme, CT. There was no history of rash or tick bite. He had been well until eight hours prior to admission when fever and headache developed.

scholarly journals EFFECT OF BASTI AND NASYA IN HEMORRHAGIC STROKE SPECIFICALLY ON BARTHEL INDEX, GRIP POWER AND NIH STROKE SCALE: A PILOT STUDY

2020 ◽  
Vol 11 (10) ◽  
pp. 33-36
Author(s):  
Jui V Gundo ◽  
Ashish A Thatere ◽  
Vaishali K Gajbhiye ◽  
Shweta P Deolekar ◽  
Prakash R Kabra
Keyword(s):  
Pilot Study ◽  
Hemorrhagic Stroke ◽  
Statistical Tests ◽  
Signs And Symptoms ◽  
Mass Effect ◽  
Cerebrovascular Diseases ◽  
Brain Parenchyma ◽  
Full Paper ◽  
Ayurvedic Treatment ◽  
The Brain

Cerebrovascular diseases include some of the most common and devastating disorders; ischemic stroke and hemorrhagic stroke. Intracranial hemorrhage usually results from rupture of blood vessel within the brain parenchyma but may also occur in patients with subarachnoid haemorrhage, if the artery ruptures into the brain substance as well as into the subarachnoid space. It produces neurological symptoms by producing mass effect on neural structures, from the toxic effects of blood itself or by increasing intracranial pressure. According to Ayurved hemorrhagic stroke can be linked with Urdhva Raktapitta. Chikitsa of Urdhva Raktapitta was Virechana and Adho Raktapitta was Vamana as stated by Charak. So initial management was planned to stabilize Prakupit Dosha and hence Basti and Nasya were selected in these 5 patients of pilot study. Observations and results obtained were encouraging and assessed on different parameters which are presented in full paper. The patients of acute hemorrhagic stroke (not less than 1yr) were selected on the basis of CT/ MRI of brain and sign- symptoms of stroke. Observation and results are mention by applying appropriate statistical tests. Clinically encouraging results were observed on signs and symptoms. Statistically significant results were observed on parameters. These results are presented in full paper in details. Combination of this Ayurvedic treatment can be helpful in treating the cases of hemorrhagic stroke however the study on the larger compound will be helpful to validate its effect on hemorrhagic stroke.

scholarly journals COVID-19 Neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital

2021 ◽  
Author(s):  
Kiran Thakur ◽  
Emily H Miller ◽  
Michael D Glendinning ◽  
Osama Al Dalahmah ◽  
Matei Banu ◽  
...  
Keyword(s):  
New York ◽  
Hospital Admission ◽  
Microglial Activation ◽  
Medical Center ◽  
Kidney Injury ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Viral Rna ◽  
Qrt Pcr ◽  
The Brain

Many patients with SARS-CoV-2 infection develop neurological signs and symptoms, though, to date, little evidence exists that primary infection of the brain is a significant contributing factor. We present the clinical, neuropathological, and molecular findings of 41 consecutive patients with SARS-CoV-2 infections who died and underwent autopsy in our medical center. The mean age was 74 years (38-97 years), 27 patients (66%) were male and 34 (83%) were of Hispanic/Latinx ethnicity. Twenty-four patients (59%) were admitted to the intensive care unit (ICU). Hospital-associated complications were common, including 8 (20%) with deep vein thrombosis/pulmonary embolism (DVT/PE), 7 (17%) patients with acute kidney injury requiring dialysis, and 10 (24%) with positive blood cultures during admission. Eight (20%) patients died within 24 hours of hospital admission, while 11 (27%) died more than 4 weeks after hospital admission. Neuropathological examination of 20-30 areas from each brain revealed hypoxic/ischemic changes in all brains, both global and focal; large and small infarcts, many of which appeared hemorrhagic; and microglial activation with microglial nodules accompanied by neuronophagia, most prominently in the brainstem. We observed sparse T lymphocyte accumulation in either perivascular regions or in the brain parenchyma. Many brains contained atherosclerosis of large arteries and arteriolosclerosis, though none had evidence of vasculitis. Eighteen (44%) contained pathologies of neurodegenerative diseases, not unexpected given the age range of our patients. We examined multiple fresh frozen and fixed tissues from 28 brains for the presence of viral RNA and protein, using quantitative reverse-transcriptase PCR (qRT- PCR), RNAscope, and immunocytochemistry with primers, probes, and antibodies directed against the spike and nucleocapsid regions. qRT-PCR revealed low to very low, but detectable, viral RNA levels in the majority of brains, although they were far lower than those in nasal epithelia. RNAscope and immunocytochemistry failed to detect viral RNA or protein in brains. Our findings indicate that the levels of detectable virus in COVID-19 brains are very low and do not correlate with the histopathological alterations. These findings suggest that microglial activation, microglial nodules and neuronophagia, observed in the majority of brains, do not result from direct viral infection of brain parenchyma, but rather likely from systemic inflammation, perhaps with synergistic contribution from hypoxia/ischemia. Further studies are needed to define whether these pathologies, if present in patients who survive COVID-19, might contribute to chronic neurological problems.

Mucormycosis in diabetes

1997 ◽  
Vol 6 (5) ◽  
pp. 363-367 ◽  
Author(s):  
MA Hopkins ◽  
DM Treloar
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Acute Infection ◽  
Signs And Symptoms ◽  
Diabetic Woman ◽  
Critical Care Nursing ◽  
Appropriate Treatment ◽  
The Central Nervous System ◽  
The Brain ◽  
Care Nursing

Mucormycosis is a rare opportunistic infection caused by ubiquitous fungi typically found in soil, spoiled foods, bread, and dust. The acute infection most commonly is rhinocerebral and is associated with metabolic acidosis. Mucormycosis spreads quickly and can progress from the paranasal area to the brain in a few days. In the case presented, a young diabetic woman had diabetic ketoacidosis and classic signs and symptoms of mucormycosis. Even after aggressive and appropriate treatment with surgical debridement and IV administration of amphotericin B, the fungus invaded the central nervous system. This article discusses current methods of treating mucormycosis and important critical care nursing considerations for patients who have the infection.

Encephalitis

2016 ◽  
Author(s):  
Tyler Martinez
Keyword(s):  
Psychiatric Symptoms ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Stiff Neck ◽  
Meningeal Irritation ◽  
Decompressive Craniotomy ◽  
Brainstem Compression ◽  
Life Threatening ◽  
Immunocompromised State ◽  
The Brain

Encephalitis is an inflammation of the brain parenchyma, typically due to a viral infection. Pure encephalitis will lack the signs and symptoms of meningeal irritation (eg, stiff neck and photophobia). New-onset seizures, cognitive deficits, new psychiatric symptoms, lethargy/coma, cranial nerve abnormalities, or movement disorders should alert the clinician to possible encephalitis. It is important to question the patient about foreign travel, immunocompromised state, and potential exposures. Empiric treatment for presumed viral encephalitis is with the antiviral acyclovir. Empiric broad-spectrum antibiotics are also typically given to cover for possible bacterial meningitis. If there are signs of elevated intracranial pressure (ICP), neurosurgical consultation should be obtained for possible decompressive craniotomy. Standard therapy for ICP (ie, hyperventilation, steroids, mannitol, hypertonic saline, and elevation of the head of the bed) should also be considered. The most concerning complication of encephalitis is the development of life-threatening cerebral edema with resultant brainstem compression and herniation.

scholarly journals COVID-19 neuropathology at Columbia University Irving Medical Center/New York Presbyterian Hospital

Brain ◽  
2021 ◽  
Author(s):  
Kiran T Thakur ◽  
Emily Happy Miller ◽  
Michael D Glendinning ◽  
Osama Al-Dalahmah ◽  
Matei A Banu ◽  
...  
Keyword(s):  
New York ◽  
Hospital Admission ◽  
Microglial Activation ◽  
Medical Center ◽  
Kidney Injury ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Viral Rna ◽  
Qrt Pcr ◽  
The Brain

Abstract Many patients with SARS-CoV-2 infection develop neurological signs and symptoms, though, to date, little evidence exists that primary infection of the brain is a significant contributing factor. We present the clinical, neuropathological, and molecular findings of 41 consecutive patients with SARS-CoV-2 infections who died and underwent autopsy in our medical center. The mean age was 74 years (38–97 years), 27 patients (66%) were male and 34 (83%) were of Hispanic/Latinx ethnicity. Twenty-four patients (59%) were admitted to the intensive care unit (ICU). Hospital-associated complications were common, including 8 (20%) with deep vein thrombosis/pulmonary embolism (DVT/PE), 7 (17%) patients with acute kidney injury requiring dialysis, and 10 (24%) with positive blood cultures during admission. Eight (20%) patients died within 24 hours of hospital admission, while 11 (27%) died more than 4 weeks after hospital admission. Neuropathological examination of 20–30 areas from each brain revealed hypoxic/ischemic changes in all brains, both global and focal; large and small infarcts, many of which appeared hemorrhagic; and microglial activation with microglial nodules accompanied by neuronophagia, most prominently in the brainstem. We observed sparse T lymphocyte accumulation in either perivascular regions or in the brain parenchyma. Many brains contained atherosclerosis of large arteries and arteriolosclerosis, though none had evidence of vasculitis. Eighteen (44%) contained pathologies of neurodegenerative diseases, not unexpected given the age range of our patients. We examined multiple fresh frozen and fixed tissues from 28 brains for the presence of viral RNA and protein, using quantitative reverse-transcriptase PCR (qRT-PCR), RNAscope, and immunocytochemistry with primers, probes, and antibodies directed against the spike and nucleocapsid regions. qRT-PCR revealed low to very low, but detectable, viral RNA levels in the majority of brains, although they were far lower than those in nasal epithelia. RNAscope and immunocytochemistry failed to detect viral RNA or protein in brains. Our findings indicate that the levels of detectable virus in COVID-19 brains are very low and do not correlate with the histopathological alterations. These findings suggest that microglial activation, microglial nodules and neuronophagia, observed in the majority of brains, do not result from direct viral infection of brain parenchyma, but rather likely from systemic inflammation, perhaps with synergistic contribution from hypoxia/ischemia. Further studies are needed to define whether these pathologies, if present in patients who survive COVID-19, might contribute to chronic neurological problems.

A state of reversed hypoxic encephalopathy following attempted suicidal hanging: a boon

2011 ◽  
Vol 52 (1) ◽  
pp. 44-46 ◽  
Author(s):  
D R Mahadeshwara Prasad ◽  
S Manjula
Keyword(s):  
Signs And Symptoms ◽  
Brain Perfusion ◽  
Normal Structure ◽  
Functional Condition ◽  
Normal Function ◽  
Brain Parenchyma ◽  
Cerebral Damage ◽  
Brain Functions ◽  
Normal Functional ◽  
The Brain

Normal functional condition of the brain is achieved by maintaining the normal structure and normal function of brain parenchyma. Reduced blood supply and deficiency of available oxygen alter brain perfusion which causes hypoxia or anoxia, and, depending on the severity, alters brain functions temporarily or permanently. This can occur in cases of hanging. Some degree of permanent cerebral damage is inevitable if hypoxic-ischaemia lasts beyond 3–5 minutes. Here we present a case report in which even though the patient was hanged for more than five minutes until the formation of a ligature mark and exhibited cyanosis, unconsciousness and seizures, the outcome was favourable with prompt and early intervention. Recovery was complete such that there were no residual signs and symptoms of reduced brain perfusion.

“Where is Dementia?” A Systematic Literature Review Exploring Neuroanatomical Aspects of Dementia

2017 ◽  
Vol 2 (15) ◽  
pp. 9-23 ◽  
Author(s):  
Chorong Oh ◽  
Leonard LaPointe
Keyword(s):  
English Language ◽  
Signs And Symptoms ◽  
Behavioral Symptoms ◽  
Journal Articles ◽  
People With Dementia ◽  
Different Types ◽  
Precise Diagnosis ◽  
Physical Changes ◽  
The Brain ◽  
Language Literature

Dementia is a condition caused by and associated with separate physical changes in the brain. The signs and symptoms of dementia are very similar across the diverse types, and it is difficult to diagnose the category by behavioral symptoms alone. Diagnostic criteria have relied on a constellation of signs and symptoms, but it is critical to understand the neuroanatomical differences among the dementias for a more precise diagnosis and subsequent management. With this regard, this review aims to explore the neuroanatomical aspects of dementia to better understand the nature of distinctive subtypes, signs, and symptoms. This is a review of English language literature published from 1996 to the present day of peer-reviewed academic and medical journal articles that report on older people with dementia. This review examines typical neuroanatomical aspects of dementia and reinforces the importance of a thorough understanding of the neuroanatomical characteristics of the different types of dementia and the differential diagnosis of them.

scholarly journals Endocrine Dysfunction in Children with Zika-Related Microcephaly Who Were Born during the 2015 Epidemic in the State of Pernambuco, Brazil

Viruses ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 1
Author(s):  
Andréia Veras Gonçalves ◽  
Demócrito de B. Miranda-Filho ◽  
Líbia Cristina Rocha Vilela ◽  
Regina Coeli Ferreira Ramos ◽  
Thalia V. B. de Araújo ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Viral Infections ◽  
Case Series ◽  
Optic Nerve Hypoplasia ◽  
Endocrine Dysfunction ◽  
Careful Monitoring ◽  
Early Puberty ◽  
Growth Impairment ◽  
Appropriate Treatment ◽  
The Brain

Congenital viral infections and the occurrence of septo-optic dysplasia, which is a combination of optic nerve hypoplasia, abnormal formation of structures along the midline of the brain, and pituitary hypofunction, support the biological plausibility of endocrine dysfunction in Zika-related microcephaly. In this case series we ascertained the presence and describe endocrine dysfunction in 30 children with severe Zika-related microcephaly from the MERG Pediatric Cohort, referred for endocrinological evaluation between February and August 2019. Of the 30 children, 97% had severe microcephaly. The average age at the endocrinological consultation was 41 months and 53% were female. The most frequently observed endocrine dysfunctions comprised short stature, hypothyroidism, obesity and variants early puberty. These dysfunctions occurred alone 57% or in combination 43%. We found optic nerve hypoplasia (6/21) and corpus callosum hypoplasia (20/21). Seizure crises were reported in 86% of the children. The most common—and clinically important—endocrine dysfunctions were pubertal dysfunctions, thyroid disease, growth impairment, and obesity. These dysfunctions require careful monitoring and signal the need for endocrinological evaluation in children with Zika-related microcephaly, in order to make early diagnoses and implement appropriate treatment when necessary.

scholarly journals Macrophages and microglia: the cerberus of glioblastoma

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Alice Buonfiglioli ◽  
Dolores Hambardzumyan
Keyword(s):  
Tumor Cells ◽  
Innate Immune System ◽  
Tumor Heterogeneity ◽  
Expression Profiles ◽  
Brain Parenchyma ◽  
Innate Immune ◽  
Malignant Growth ◽  
Neoplastic Cells ◽  
Functional Roles ◽  
The Brain

AbstractGlioblastoma (GBM) is the most aggressive and deadliest of the primary brain tumors, characterized by malignant growth, invasion into the brain parenchyma, and resistance to therapy. GBM is a heterogeneous disease characterized by high degrees of both inter- and intra-tumor heterogeneity. Another layer of complexity arises from the unique brain microenvironment in which GBM develops and grows. The GBM microenvironment consists of neoplastic and non-neoplastic cells. The most abundant non-neoplastic cells are those of the innate immune system, called tumor-associated macrophages (TAMs). TAMs constitute up to 40% of the tumor mass and consist of both brain-resident microglia and bone marrow-derived myeloid cells from the periphery. Although genetically stable, TAMs can change their expression profiles based upon the signals that they receive from tumor cells; therefore, heterogeneity in GBM creates heterogeneity in TAMs. By interacting with tumor cells and with the other non-neoplastic cells in the tumor microenvironment, TAMs promote tumor progression. Here, we review the origin, heterogeneity, and functional roles of TAMs. In addition, we discuss the prospects of therapeutically targeting TAMs alone or in combination with standard or newly-emerging GBM targeting therapies.

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