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MODULE 10: The Brain
PART 5 OF 7
Stina’s IL-1β and IL-6 have been elevated for years, not days. This page is about what sustained — not acute — exposure does to a barrier built for selectivity.
Slide 1 Transcript
PATIENT CHART
STINA
THIS PART
Ages 45
PRESENTING WITH
Brain fog, pressureThe force exerted by gases in the respiratory system, affecting airflow and gas exchange. headache
TESTS ORDERED
MRI – found white matterThe outer portion of the spinal cord made of myelinated nerve fibers that transmit signals. hyperintensities
DIAGNOSIS
Neuroinflammatory White-Matter Injury
CHART CLUES
COLLECTED AS YOU GO
Age-Excessive White Matter Hyperintensities (WMH) on Brain MRI
Childhood Recurrent Fever Traced to the Hypothalamic Set-Point
Positional Pressure Headache — Intracranial Pressure / CSF Space
An Intact BBB Should Seal the Brain — Yet the Spots Appear
Chronic IL-1β/IL-6 Loosen BBB Tight Junctions — Microglia Activate
WMH + ‘Brain Fog’ Are One Finding — Neuroinflammatory White-Matter Injury
Chart Clue #10 — the Brain as Another Target Organ
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Story1
A single fever, a brief surge of cytokines, the barrier shrugs off. Stina’s problem was never a single surge. Her inflammation ran for decades — a low, relentless tide of IL-1β and IL-6 lapping at every vessel in her body, including the carefully sealed ones in her brain. Walls built to withstand a storm can still erode under a tide that never goes out. This is the page where the blood-brain barrierA selective barrier that prevents harmful substances from entering the brain., intact in Part 4, begins to leak.
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Slide 2 Transcript
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story2
Chronic IL-1β and IL-6 act directly on the barrier’s endothelial cellsThe basic structural and functional units of life.. They trigger signaling that loosens and downregulates the tight junction proteinsLarge molecules made of amino acids with various functions in the body. holding the cells together, and they make the endotheliumThe innermost layer of blood vessels, composed of simple squamous epithelial cells, which reduces fr “stickier,” expressing adhesionThe tendency of water molecules to stick to other substances. moleculesGroups of atoms bonded together. that grab passing immune cells. As the junctions loosen, the barrier’s selectivity fails: inflammatory cytokines and even immune cells slip from blood into brain tissue. Once inside, they rouse the brain’s resident immune cells — the microgliaSmall CNS glial cells that act as macrophages, cleaning up debris and pathogens. — which shift from quiet surveillance into an activated, inflammatory state, releasing still more cytokines. This is the pivotal handoff: systemic inflammation becomes neuroinflammation.
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story3
For Stina, the fire that had been confined to her blood and tissues now had a way into the one organ that was supposed to be off-limits.
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Slide 7 Transcript
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FINDING!
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Slide 7 Transcript
NEXT PART
Once the wall is breached, the damage doesn’t stay invisible — it accumulates in the wiring. Next: how neuroinflammation becomes the very spots on Stina’s scan.
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← Familial Mediterranean Fever — case home
All pages for Module 10 — The Brain & the Blood–Brain Barrier
10.0 Module Overview
10.1 Spots on the Scan
10.2 The Command Center
10.3 Cushions and Currents
10.4 The Wall
10.5 Breaching the Wall
10.6 White Matter Under Fire
10.7 Neuroinflammation
10.8 Conclusion and Assessment
10.9 Evidence Behind the Case
All Modules
- Anatomical Language, Membranes & Homeostasis
- Just Enough Chemistry
- The Cell & Its Transport
- Making Cells & Proteins
- The Integumentary System
- The Skeletal System
- The Muscular System
- Nervous Tissue & the Senses
- The Spinal Cord
- The Brain & the Blood–Brain Barrier
- The Autonomic Nervous System
- Special Senses (in developmentThe process of growth and differentiation.)
- The Endocrine System
- Blood
- The Heart
- Blood Vessels
- The Digestive System
- The Respiratory System
- The Urinary System
- Fluids, Electrolytes & Acid–Base Balance
- The Reproductive System
- The Immune System
List of terms
- pressure
- white matter
- blood-brain barrier
- cells
- proteins
- endothelium
- adhesion
- molecules
- microglia
- development