Rzaska Marta, Niewiadomski Seweryn, Karwacki Zbigniew
Department of Neuroanaesthesia, Medical University of Gdansk, Poland.
Anaesthesiol Intensive Ther. 2017;49(5):387-392. doi: 10.5603/AIT.2017.0080.
Central nervous system (CNS) infections may involve the meninges, brain and/or spinal cord. The most common etiologic agents are Streptococcus pneumoniae, group B Streptococci, Neisseria meningitidis, Haemophilus influenzae, and Listeria monocytogenes. CNS is characterized by specific structure and function. Despite a unique system of brain barriers and autonomous immune system, CNS is very susceptible to microorganisms which may invade directly, via the blood, or less frequently by reverse axonal transport. The complex process of bacteria and activated polymorphonuclear leukocyte transfer to the subarachnoid space, which is devoid of natural immune defence mechanisms, initiates an inflammatory response that subsequently spreads to the brain tissue. Consequences of these changes include damage to the blood-brain barrier, development of vasogenic cerebral oedema, and intracranial pressurevolume disturbances leading to impaired CNS perfusion.
中枢神经系统（CNS）感染可能累及脑膜、脑和/或脊髓。最常见的病原体是肺炎链球菌、B族链球菌、脑膜炎奈瑟菌、流感嗜血杆菌和单核细胞增生李斯特菌。中枢神经系统具有特定的结构和功能。尽管存在独特的脑屏障系统和自主免疫系统，但中枢神经系统极易受到微生物的侵袭，这些微生物可能直接侵入、通过血液侵入，或较少见地通过逆向轴突运输侵入。细菌和活化的多形核白细胞转移至缺乏天然免疫防御机制的蛛网膜下腔这一复杂过程，引发了炎症反应，随后炎症扩散至脑组织。这些变化的后果包括血脑屏障受损、血管源性脑水肿的发展以及颅内压容积紊乱，进而导致中枢神经系统灌注受损。
