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Cerebritis |
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Cerebritis and
cerebral abscess are examples of severe focal infection of the brain caused by a
wide range of organisms
Focal inflammation of the parenchyma of the brain, termed cerebritis,
frequently leads to formation of a cerebral abscess.
Inflammation patterns
develop in four main ways:
1 Secondary to meningitis, caused by same organism types.
2 Local extension from sepsis in middle ear/mastoid cavities.
3 Haematogenous, particularly associated with bacterial endocarditis, cyanotic
congenital heart disease, and pulmonary bronchiectasis.
4 Trauma following open injuries to the CNS.
Areas of brain affected by cerebritis appear as ill-defined areas of swelling,
which are congested and soft on cut surface, being composed of necrotic brain
infiltrated by neutrophils.
An abscess is a rounded cavity, typically 1-2 cm in
diameter, filled with pus and walled off both by gliosis and by fibroblasts
derived from tissue adjacent to blood vessels. Certain brain areas are preferred
sites for abscess formation, according to aetiology eg, infection of the middle
ear causes abscesses in temporal lobe/cerebellum, nasal sinus infection causes
abscesses in frontal lobes, chronic lung sepsis tends to cause abscesses in
frontal lobes, and septic emboli tend to cause abscesses in parietal lobes. |
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