“Brain In Flame”: Pathology And Imaging Of Noninfectious Cns Inflammation

Abstract

The brain is an actively regulated site of immune surveillance. Microglia are the brain's resident immune cells and their activation is a hallmark of CNS pathologies ranging from trauma and neurodegeneration to vascular and neoplastic disease. Inflammasomes are large multiprotein complexes within the microglia that mediate their proinflammatory, excitotoxic responses. We will examine the role of neuroinflammation in a spectrum of pathologies with an emphasis on trauma, autoimmune encephalitis (the “brain in flame"), vasculitis (vessels “on fire"), dementing disorders and primary brain tumors. Findings suggestive of neuroinflammation on conventional MRI will be emphasized along with PET TSPO (translocator protein) imaging that can detect early or abnormally prolonged microglial activation.