The physiopathogenetic basis for the angiographic diagnosis of bacterial infections of the brain and its coverings in children. II. Cerebritis and brain abscess.
Most of the small (50--60 micrometers) vessels nourish exclusively the cerebral cortex, whereas larger caliber (80--150 micrometers) arteries penetrate the entirety of the cortical layer to enter the underlying white matter. A single layer of nonfenestrated endothelial cells, surrounded by a continuous layer of basement membrane (which in places splits to envelope a pericyte), and perivascular glial cells attached to the outer surface of this basement membrane, with no pericapillary space, represent the anatomical structure of the blood-brain barrier (BBB). Concentrated electrolyte solutions and increases in mean arterial pressure may reopen the BBB. Water-soluble contrast media used in cerebral angiography are hypertonic solutions of iodinated salts. In cerebritis, one observes a very typical angiographic picture: 'laminar' staining of the gyri. The intervening sulci appear as negative images. In brain abscess, one may note angiographic evidence of a space-occupying lesion, a capsular stain in the granulation tissue surrounding the abscess, 'halo' formation and 'pooling' of contrast media in the sulci, and 'laminar' staining of the gyri.
D001424:Bacterial Infections / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001812:Blood-Brain Barrier; D001922:Brain Abscess / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000503:physiopathology; D002199:Capillary Permeability; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002648:Child; D004660:Encephalitis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans