Pathologies of central nervous system includes inflammatory and infective diseases of brain and spinal cord. Fibroblasts play an important role in healing. Fibroblasts are the cells where collagen formation take place. Fibroblast secrete collagen, and collagen is responsible for repairing of cells. Damaged area can not be recovered but can heal to some extent. Collagen will replace the damaged area, and recovery take place in a sequential manner. Swelling is followed by edema and macrophages monocytes reach at the affected area and removes dead tissue. Then, fibroblastic activity starts and collagen secretion take place, and collagen fills the gap. It is followed by scar formation and then healing starts.
Nerve endings are present throughout the skin which carries pain sensation to brain. In liver, if pathology is inside the liver, patient do not experiences any kind of pain, but if capsule is involved patient will experience pain. In tuberculosis patient have no pain though he is experiencing the worst symptoms like extreme inflammation of lungs, haemoptysis (blood in sputum) still patient do not experiences pain as there are no nerve endings inside liver.
Inflammatory Pathologies of central nervous system
In inflammatory pathologies of central nervous system multiple sclerosis is most commonly occurring inflammatory disease of brain. Transverse myelitis is most common inflammatory disease of spinal cord. Other inflammatory diseases of CNS are rare.
Multiple sclerosis is an autoimmune disease. Brain and brain stem is involved. Cells of body starts damaging its own tissues and there is an inflammatory response. Myelin sheath and oligodendrocytes are damaged, macrophages reaches at the affected area and engulfs the dead tissue. Fibroblastic activity starts and collagen secretion take place and gap is filled. But, dead myelin sheath and oligodendrocytes can not be recovered. Same functional activity is not achieved.
“Myela” means spinal cord and “itis” means inflammation. It is the inflammation of transverse segment of spinal cord. Inflammation of a part of spinal cord may cause neurological symptoms in dermatomes or limbs. this condition is called transverse Myelitis. Spinal cord basically monitors bowel and bladder control. Lower limb is involved in transverse myelitis. But, lower limb may also be paralyzed because of some trauma so, MRI is performed for confirmation. Whitish spots in MRI represents inflammation of spinal cord. In this way transverse myelitis is confirmed.
Infective Pathologies of CNS
Any fungal, viral or bacterial foreign particle enters the human body, caused inflammation and damages the tissues of body. This is called infection. Body have same method to fight against all kinds of infections or inflammations. Body increases its vascular permeability and macrophages engulf the damaged tissue or foreign body and fibroblastic activity secretes collagen for repair. But in case the antigens entering human body have stronger immunity and macrophages are unable to kill them. Then we need to use antibiotics or other medications externally to kill antigens.
Meningitis is the inflammation of meninges of brain. Brain consists of three layers or coverings called meninges of brain.
- Dura mater
- Arachnoid mater
- Pia mater
These coverings of brain are sterile. Hence, there is no chance of infection. But in case of IV injection if the syringe is contaminated with virus, fungus or bacteria. These antigens will enter the blood stream. If not controlled by the immune system these antigens will enter the brain and may cause infection of meninges. Meningitis might be fungal, bacterial, viral or chemically caused. Patients with meningitis complains high grade fever, neck stiffness, severe headache because nerve endings are present in meninges. Lumbar puncture (CSF sample is withdrawn from meninges in the lumbar region and sent for lab test) is performed to confirm meningitis. Our duty is to control fever, reduce neck stiffness and maintain electrolyte balance. So medication is prescribed accordingly.
Encephalitis is the inflammation of brain. Encephalitis do not cause head ache as brain do not have nerve endings. This is the only symptom which differentiates it from meningitis. Other symptoms and treatment is similar to meningitis.
Brain abscess is collection of infected material or substances coming from infections. CT scan is performed as a confirmatory investigation. This infected material present in this abscess is removed through burr hole craniotomy. Antibiotics and analgesics are prescribed.