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 minimal perivascular space minimal connective tissue [collagen and elastin] CNS TRAUMA Concussion: temporary loss of function unconsciousness for brain paralysis for spinal cord CNS TRAUMA Contusion: disruption of architecture with haemorrhage at impact site or distant site CNS TRAUMA Laceration: severe and permanent disruption of tissues with haemorrhage and necrosis Haemorrhage Acute brain swelling and unregulated vasodilation Myelomalacia - necrosis or softening of spinal cord Type-1 disk protrusion Haemorrhagic myelomalacia RAISED INTRACRANIAL PRESSURE oedema haemorrhage abscess tumour generalised inflammation increased CSF production decreased CSF drainage generalised signs 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? protection expansion no lymphatics tight junctions tight junctions & astrocyte processes BBB protection - p expansion no lymphatics tight junctions tight junctions & astrocyte processes BBB protection - p expansion - c no lymphatics tight junctions tight junctions & astrocyte processes BBB protection - p expansion - c no lymphatics - r tight junctions tight junctions & astrocyte processes BBB protection - p expansion - c no lymphatics - r tight junctions – p & r tight junctions & astrocyte processes BBB protection - p expansion - c no lymphatics - r tight junctions – p & r tight junctions & astrocyte processes BBB – p & r capillaries not fenestrated [except choroid plexus] end arterioles minimal interstitial space minimal perivascular space minimal connective tissue [collagen and elastin] capillaries not fenestrated – p & r [except choroid plexus] end arterioles minimal interstitial space minimal perivascular space minimal connective tissue [collagen and elastin] capillaries not fenestrated – p & r [except choroid plexus] end arterioles - p minimal interstitial space minimal perivascular space minimal connective tissue [collagen and elastin] capillaries not fenestrated – p & r [except choroid plexus] end arterioles - p minimal interstitial space - c minimal perivascular space minimal connective tissue [collagen and elastin] 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] 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] 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 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 BRAIN SWELLING ↑ tissue / fluid 2o fluid and pressure changes fatal: * brain abscess in a calf * Coenurus cerebralis cyst 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 Herniation of brain tissue right cerebral swelling to left under falx cerebri pressure on thalamus Herniation of brain tissue right cerebral swelling caudally under tentorium cerebelli pressure on midbrain Herniation of brain tissue further swelling cerebellum through foramen magnum pressure on medulla oblongata VASCULAR AND CIRCULATORY LESIONS blood supply Brain - carotid and vertebral arteries, circle of Willis anastomoses pia-arachoid, then end arteries collateral supply poor 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 VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Vasculitis, eg EHV-1 arteritis in a horse VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:Thrombo-embolisim, eg Salmonella septicaemia in pigs VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Hypoxia/ischaemia, eg neonatal seizures in a foal anaesthetic accident in a dog VASCULAR AND CIRCULATORY LESIONS Vascular and circulatory lesions from:- Coagulopathies, eg DIC in septic mastitis VASCULAR AND CIRCULATORY LESIONS Question: Why should grey matter be more susceptible than white mater to many vascular and circulatory insults? VASCULAR AND CIRCULATORY LESIONS Infarction