化脑双语袁宝莉.pptVIP

化脓性脑膜炎purulent meningitis;Abbreviations PM purulent meningitis CSF cerebrospinal fluid CNS central nervous system ICP intracranial pressure BBB blood-brain barrier WBC white blood cell NC neutrocyte; INTRODUCTION Purulent Meningitis (PM) is one of serious bacterial infection. PM is associated with a high rate of acute complications and risk of chronic sequelae. PM is quite common CNS disorders in childhood, and it should be included in the differential diagnosis of altered mental status.;概念;病原学(1); 脑膜炎球菌;肺 炎 球 菌; Common bacteria The first 2 month: escherichia coli ; staphylococcus aureus; 2 month~12 yr: Pneumococcus; Meningococcus; Hemophilus influenzae type b. ;病原学(2);发病机制(1); The risk factors 1. Lack of immunity: young age, defects of T-lymphocyte, defects of immunoglobulin, defects of the complement system or properdin system 2. Environment Congenital or acquired CSF leak: such as cranial defect or middle ear fistulas, basal skull fracture, lumbosacral dermal sinus, penetrating cranial trauma ;;[ 回顾 ] 中枢神经系统脑膜的解剖及脑脊液的循环; PATHOGENESIS Bacteria attack to the mucosal epithelial cell receptors by pili, enter the circulation, penetrate the BBB (blood-brain barrier) to the CSF, colonize and multiply, then incite inflammatory response and polymorphonuclear cell infiltration, which produce TNF, IL-1, PG-2 and other cytokines. ;致病菌入侵途径;发病机制(2); PATHOLOGY Meningeal exudation and varying thickness Vascular changes: vasculitis , thrombosis, necrosis or occlusion of small vascules Cerebral infarction Increased ICP Ventriculitis Hydrocephalus, communicating Damage of the cerebral cortex ; 轻症化脑的病理变化 软脑膜及蛛网膜炎、表层脑组织为主的炎 症反应，炎症渗出物主要在大脑顶部表面。 重症化脑的病理变化 除轻症的改变外，还出现血管病变、