🧠Pathology of the Central Nervous System (CNS)
1. Introduction
The central nervous system (CNS) includes the brain and spinal cord. CNS pathology refers to diseases or disorders that affect the structure or function of the CNS. These can be congenital, inflammatory, infectious, vascular, degenerative, neoplastic, or traumatic in nature.
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2. Common CNS Disorders by Type
🔹 A. Vascular Disorders
Stroke (Cerebrovascular Accident, CVA):
Ischemic stroke: Blocked blood supply due to thrombus/embolus.
Hemorrhagic stroke: Bleeding in brain tissue (e.g., aneurysm rupture).
Symptoms: Sudden weakness, speech issues, facial droop.
Transient Ischemic Attack (TIA): Mini-stroke with temporary symptoms.
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🔹 B. Infectious Diseases
Meningitis:
Inflammation of meninges.
Causes: Bacteria (e.g., Neisseria meningitidis), viruses.
Symptoms: Fever, neck stiffness, headache.
Encephalitis:
Inflammation of brain parenchyma, usually viral (e.g., Herpes simplex virus).
Symptoms: Altered consciousness, seizures.
Brain abscess:
Localized pus collection due to infection.
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🔹 C. Inflammatory/Autoimmune Disorders
Multiple Sclerosis (MS):
Autoimmune demyelinating disorder.
Features: Relapsing-remitting weakness, sensory changes, vision problems.
Guillain-Barré Syndrome (though peripheral, relevant here):
Rapid-onset muscle weakness due to immune attack on nerves.
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🔹 D. Neurodegenerative Diseases
Alzheimer’s Disease:
Progressive dementia with amyloid plaques, neurofibrillary tangles.
Parkinson’s Disease:
Loss of dopamine neurons in substantia nigra.
Symptoms: Tremor, rigidity, bradykinesia.
Huntington’s Disease:
Genetic, progressive movement disorder with cognitive decline.
Amyotrophic Lateral Sclerosis (ALS):
Degeneration of motor neurons → progressive muscle weakness.
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🔹 E. Neoplasms (Brain Tumors)
Gliomas: e.g., Glioblastoma multiforme (most aggressive)
Meningiomas: Usually benign tumors of the meninges.
Medulloblastomas: Common in children.
Symptoms depend on location: seizures, headaches, motor changes.
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🔹 F. Traumatic Injuries
Concussion: Mild traumatic brain injury.
Contusion: Bruising of brain tissue.
Intracranial hemorrhages:
Epidural, Subdural, Subarachnoid, Intracerebral hemorrhages.
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🔹 G. Congenital Disorders
Spina bifida: Failure of neural tube closure.
Hydrocephalus: Excess cerebrospinal fluid (CSF) in ventricles.
Cerebral palsy: Non-progressive motor disorder from birth injury.
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3. Diagnostic Tools
MRI, CT scan, EEG, Lumbar puncture (CSF analysis), Biopsy, Blood tests
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4. Pharmacological Management Examples
Condition Drugs Used
Stroke Antiplatelets, thrombolytics (tPA)
Meningitis Antibiotics, corticosteroids
MS Immunomodulators (e.g., interferon)
Parkinson’s Levodopa + Carbidopa
Alzheimer’s Donepezil, memantine
Seizures Antiepileptics (phenytoin, valproate)
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