Malignant Meningitis

The brain is surrounded by several layers of protective coverings collectively called meninges.  The semi-translucent innermost layers, called the leptomeninges, form a "shrink-wrap" around the brain that allows for easy flow of cerebrospinal fluid (CSF) along the outer surface of central nervous system structures. Unfortunately, it also allows for easy spread of neoplastic cells.  The image shows the inferior aspect... Continue Reading →

Fungal Encephalitis with Angioinvasion

Infection of the brain by fungal organisms, termed fungal encephalitis, is an uncommon, but deadly disease that tends to occur in persons with compromised immune systems or, as in this case, uncontrolled diabetes.  Zygomycetes, a group of fungal organisms that includes Mucor and Rhizopus, has a particular proclivity to invade blood vessels (pictured here), which can... Continue Reading →

Leptomeningitis and Perivascular Spread

Many blood vessels that supply the brain and spinal cord initially run within the covering layers on the external surface, called the leptomeninges (also known as the pia-arachnoid), before plunging into the deeper neural tissue. As the vessel transitions from the outer layers into deeper tissue, the perivascular space immediately surrounding the vessel, called Virchow-Robin space, may provide a conduit for infectious/inflammatory processes. ... Continue Reading →

Infection/Inflammation of Spine and Nerve Roots

The spinal cord is covered by protective outer connective tissue layers called the pia-arachnoid or leptomeninges.  Inflammatory or infectious processes that involve the leptomeninges, called leptomeningitis, can also involve the adjacent spinal nerve roots, which similarly have an outer covering of connective tissue that is continuous with the leptomeninges.  The image depicts a spinal cord with acute... Continue Reading →

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