Eng / Meningeal syndrome
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Violation of liquorodynamics in meningitis
Leads to the development of acute hydrocephalus, which causes:
congestive changes in the fundus
paroxysmal headaches
often convulsions.
Meningitis
The pathognomonic for acute meningitis is
a combination of headache with a pronounced febrile reaction.
headache is accompanied by vomiting, which usually occurs in the first days of the disease.
Distinctive features of vomiting in meningitis should be considered: its intensity (“fountain”), the sudden appearance without previous nausea and the absence of plaque on the tongue (coated tongue), as in other, in particular gastrointestinal diseases.
Causes of vomiting in purulent meningitis-
increased intracranial pressure
directly pathological process in the meninges
toxic effect on the vomiting center from the inflammatory liquor
Vomit
- an early symptom and its occurrence almost always coincides with other initial manifestations of acute meningitis.
Accession or a sharp increase in vomiting in the late period (3-4th week of illness) more often indicates a complicated course of the process (ventriculitis).
Vomiting often disappears after a lumbar puncture.
Meningitis
Meningitis is accompanied by: 1. increased production of CSF and the development of ICH; 2. increased permeability of the BBB; 3. toxic damage to the substance of the brain; 4. violation of cerebral circulation, (especially microcirculation); 5. violation of liquorodynamics; 6. as a result - brain hypoxia
Clinic of bacterial purulent meningitis
characterized by a combination general infectious symptoms
the presence of meningeal and cerebral syndromes less often focal neurological symptoms.
Classic triad: fever
neck muscle stiffness disturbance of consciousness.
When the process is localized mainly on the convex surface of the cerebral hemispheres
the clinical picture is dominated by signs of irritation of the cortex:
with psychomotor agitation tonic-clonic seizures
disturbances of sensitivity of the central character.
When the process is localized on the basis of the brain
early damage to the cranial nerves, and especially the oculomotor, visual, auditory and facial, which leads to decreased vision and hearing, ptosis, double vision, paralysis of the external and internal muscles of the eye, sluggish pupillary response to. light, anisocoria.
In cases of severe initial symptoms, shortness of breath may be observed in the absence of clear clinical changes in the respiratory system and cardiovascular disorders.
Diagnostics
Fundus examination
Skull x-ray
Echoencephalography
Sonography (in children under one year old)
EEG
CT and MRI of the brain