Nervous System
Li shuhua
Pathologic significance
1) The high degree of localization of function
2) The same pathologic process to manifest
clinically in a completely different way when
it infects a different part of the system
3) Pathologic responses are usually limited
4) Double-edged swords,skulls and vertebral
canal
5) Extracranial metastasis of malignant tumors
is not frequently
6) Except organic lesions,psychiatric symptoms
are manifested,
neuron
neurofibril
Neuroglial cell
Basic reactions
? Neurons
1 Loss of Nissl bodies
（ Chromatolysis ）
2 Acute necrosis of neurons
? Red nerve cells
? Ghost cell
中央尼氏体消失
鬼影细胞
3 The chronic process of neurons
? Simple atropy
? Neurofibrillary tangles
? Intraneuronal body formation
?
4 Axonal
Simple atropy
神经原纤维缠结
Lewy 小体
Nerve fiber degenaration
wallerian degeneration
demyelination
轴
索
断
裂
?
Neuroglia
1,Astrocytes
◆ Proliferation repair,healing
glial,scar” GFAP（ +）
◆ Hypertrophy,swelling astrocytes
2,Oligodendrocytes, satellite phenomenon
3,Ependymocyte
◆ Granular ependymitis
◆ Cytomegalovirus inclusion
胶质瘢痕
卫
星
现
象
4 Microglia
? Accumulate abundant
intracellular lipids to form foamy
macrophages,termed gitter cells
? The nuclei develop pyknosis to
form rod cells。
? Microglial nodules and
neurophagia
小胶质细胞吞噬脂质
格
子
细
胞
小胶质细胞吞噬
含铁血黄素
噬神经现象
胶质小结
Infections
Routes of infection
1,The blood stream,the most common
2,Direct implantation,traumatic or iatrogenic
3,Local extension
4,Through the peripheral nerve
Meningitis
Classification:
? Acute pyogenic
? Acute lymphocytic
? Chronic
Epidemic cerebrospinal
meningitis
Etiology:
Cause,escherichia coli
patient
?Infants and children
Epidemic cerebrospinal
meningitis
Pathogen,Meningococcus
Pathogenesis,Epidemic (winter and
spring）
Routes of infection,Respiratory
Patients or germ carrier
spray the susceptible
脑膜炎双球菌
Morphology
?Respiratory stage
?Septicemia stage
?Meningitis stage
? characteristic lesion
Meningitis stage
Dilation and congestion of vessels in meninges
Mild,Pyoid exudates distribute along the vessels
Exudates obstruct the ventricles
Severe,Subarachnoid space are filled with creamy
exudates
Microscopically：
1,High dilation and congestion of
vessels in meninges
2,subarachnoid space are filled with
pyoid exudates
3,Nervous tissue is affected slightly
Severe,angitis and thrombosis
red infarction
流脑
流行性脑脊髓膜炎
流
行
性
脑
脊
髓
膜
炎
Clinical course
? Systemic sysptoms,fever,chill etc.
? Symptom within the nervous system
1 Intracranial pressure,
Triads,headache,projectile vomiting，
visual disorder。
2 Meningismus：
Kernig（＋）,Stiffneck,episthotonus，
3 cerebrospinal fluid change
角弓反张
Complications
? Hydrocephalus
? Cranial palsy
? Angitis — cerebral ischemia,infarction
? Fulminating meningococcemia,
DIC,shock,purpura，
severe hemorrhage in adrenal gland，
nonfunction of adrenal cortex 。
脑
积
水
Epidermic encephalitis B
?Pathogenesis：
?Japanese encephalitis virus
Infection sources or intermediate host
mosquito
human
Reproduce in focal endothelial cell and
mononuclear phagocytic system
Silent infection hypoimmunity
viremia
Invade CNS
Pathologesis
Morphology
?Location,the whole gray matter of CNS,
the most severe in cerebral cortex,basal
nuclei,thalamus opticus
?Grossly：
Congestion in meninges,hydrocephalus
Cut surface,discrete granular malacoma
Microscopically：
? Vascular change and inflammation
? Degeneration and necrosis of neurons
? Characteristic cribrose malacoma
? Proliferation of glial cells
Satellitosis and neuronophagia
血管套
软化灶
Clinical course
? Cranial nerve palsy
? Cerebral edema,increased intracranial
pressure
? Meningeal irritation sign
? CSF change
CSF ECM EEB
Pressure
Apperance clouding clear
Protein
Cellurity
Glucose Normal or slightly discreased
Bacteria (+) (-)
Li shuhua
Pathologic significance
1) The high degree of localization of function
2) The same pathologic process to manifest
clinically in a completely different way when
it infects a different part of the system
3) Pathologic responses are usually limited
4) Double-edged swords,skulls and vertebral
canal
5) Extracranial metastasis of malignant tumors
is not frequently
6) Except organic lesions,psychiatric symptoms
are manifested,
neuron
neurofibril
Neuroglial cell
Basic reactions
? Neurons
1 Loss of Nissl bodies
（ Chromatolysis ）
2 Acute necrosis of neurons
? Red nerve cells
? Ghost cell
中央尼氏体消失
鬼影细胞
3 The chronic process of neurons
? Simple atropy
? Neurofibrillary tangles
? Intraneuronal body formation
?
4 Axonal
Simple atropy
神经原纤维缠结
Lewy 小体
Nerve fiber degenaration
wallerian degeneration
demyelination
轴
索
断
裂
?
Neuroglia
1,Astrocytes
◆ Proliferation repair,healing
glial,scar” GFAP（ +）
◆ Hypertrophy,swelling astrocytes
2,Oligodendrocytes, satellite phenomenon
3,Ependymocyte
◆ Granular ependymitis
◆ Cytomegalovirus inclusion
胶质瘢痕
卫
星
现
象
4 Microglia
? Accumulate abundant
intracellular lipids to form foamy
macrophages,termed gitter cells
? The nuclei develop pyknosis to
form rod cells。
? Microglial nodules and
neurophagia
小胶质细胞吞噬脂质
格
子
细
胞
小胶质细胞吞噬
含铁血黄素
噬神经现象
胶质小结
Infections
Routes of infection
1,The blood stream,the most common
2,Direct implantation,traumatic or iatrogenic
3,Local extension
4,Through the peripheral nerve
Meningitis
Classification:
? Acute pyogenic
? Acute lymphocytic
? Chronic
Epidemic cerebrospinal
meningitis
Etiology:
Cause,escherichia coli
patient
?Infants and children
Epidemic cerebrospinal
meningitis
Pathogen,Meningococcus
Pathogenesis,Epidemic (winter and
spring）
Routes of infection,Respiratory
Patients or germ carrier
spray the susceptible
脑膜炎双球菌
Morphology
?Respiratory stage
?Septicemia stage
?Meningitis stage
? characteristic lesion
Meningitis stage
Dilation and congestion of vessels in meninges
Mild,Pyoid exudates distribute along the vessels
Exudates obstruct the ventricles
Severe,Subarachnoid space are filled with creamy
exudates
Microscopically：
1,High dilation and congestion of
vessels in meninges
2,subarachnoid space are filled with
pyoid exudates
3,Nervous tissue is affected slightly
Severe,angitis and thrombosis
red infarction
流脑
流行性脑脊髓膜炎
流
行
性
脑
脊
髓
膜
炎
Clinical course
? Systemic sysptoms,fever,chill etc.
? Symptom within the nervous system
1 Intracranial pressure,
Triads,headache,projectile vomiting，
visual disorder。
2 Meningismus：
Kernig（＋）,Stiffneck,episthotonus，
3 cerebrospinal fluid change
角弓反张
Complications
? Hydrocephalus
? Cranial palsy
? Angitis — cerebral ischemia,infarction
? Fulminating meningococcemia,
DIC,shock,purpura，
severe hemorrhage in adrenal gland，
nonfunction of adrenal cortex 。
脑
积
水
Epidermic encephalitis B
?Pathogenesis：
?Japanese encephalitis virus
Infection sources or intermediate host
mosquito
human
Reproduce in focal endothelial cell and
mononuclear phagocytic system
Silent infection hypoimmunity
viremia
Invade CNS
Pathologesis
Morphology
?Location,the whole gray matter of CNS,
the most severe in cerebral cortex,basal
nuclei,thalamus opticus
?Grossly：
Congestion in meninges,hydrocephalus
Cut surface,discrete granular malacoma
Microscopically：
? Vascular change and inflammation
? Degeneration and necrosis of neurons
? Characteristic cribrose malacoma
? Proliferation of glial cells
Satellitosis and neuronophagia
血管套
软化灶
Clinical course
? Cranial nerve palsy
? Cerebral edema,increased intracranial
pressure
? Meningeal irritation sign
? CSF change
CSF ECM EEB
Pressure
Apperance clouding clear
Protein
Cellurity
Glucose Normal or slightly discreased
Bacteria (+) (-)
