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Neuro Anatomy > Meningitis > Flashcards

Meningitis Flashcards

1
Q

Meningitis

A

Meninges of brain and spinal cord become inflamed

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2
Q

PCA and arachnoid become

A

Congested and opaque

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3
Q

Inflammation can extend

A

down into first and second laters of cortex and spinal cord producing thrombosis of cortical veins

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4
Q

Meningitis belt

A

Sub-Saharan Africa

Incidence is 5-10x higher

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5
Q

Most commonly affected

A

Children and older adults

Individuals w/ compromised immune system

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6
Q

Infection carried by

A

Blood products or other fluids and can case changes in cerebral capillary endothelium —> BBB rails to prevent enters into brain or CSF

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7
Q

Brain lacks

A

Lymphatic system to help fight infection

Leukocytes in the brain increase

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8
Q

Cells recruited to fight infection - damage

A

Surrounding brain tissue by release of cytotoxic free radicals and excitatory AA like glutamate

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9
Q

Response to inflammation

A

Can block the CSF creating hydrocephalus, edema and increased ICP

Vasculitis can lead to infarction

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10
Q

Decreased in vertebral blood flow

A

Can cause a drop in glucose levels of CSF

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11
Q

Viral meningitis

A

Most common — enterovirusus, herpes simplex virus 2, EBV in adolescence/early adult

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12
Q

Other causes of viral meningitis

A

Systemic lupus
Sarcoid tumors
Drugs/chemicals (NSAIDS)

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13
Q

Tuberculous meningitis

A

Mycobacterium TB via inhalation

Abscess or SC disease

Cysts and lymphocytes + elevated protein levels

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14
Q

Bacterial meningitis

A

Organisms located in Mucosal surfaces of upper respiratory ‘

Bacteria in birth canal can transfer

Neonates: Strep, eschericha coli, listeria monocytogenes,

Geriatric: strep pneumoniae, neisseria meningitis

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15
Q

Bacterial meningitis process

A

Inflammation initially in subarachnoid then spreads to adj brain tissue —>

vasculitis starts in small subarachnoid vessels —>

thrombin obstruction can decrease cerebral perfusion resulting in ischemic lesions

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16
Q

Early symptoms

A

Fever
HA
Stiff and painful nick

Pain in lumbar areas and posterior aspects of thigh

17
Q

Kernig sign

A

Pain w/ combined hip flexion and knee ext

18
Q

Brudzinski test

A

Passive neck flexion will be painful and cause flexion of hips and knees

19
Q

S/S in infants and children

A 
Fever
Vomiting
Decreased feeding
Bulging font Anel’s
Seizure
High pitched cry
20
Q

Symptoms develop in

A

Hours for viral

Days to weeks, fungal or tuberculous

Pyogenic bacteria - S/S can develop in 4-24 hours

21
Q

Only definitive means of obtaining dx

A

Lumbar puncture—>

Elevated mono nuclear cells
Normal glucose level
Mild increase in protein levels
Absence of bacterial organism

22
Q

W/out antibiotics

A

Death can occur — prompt dx ciritical

23
Q

Most common cause in children

A

Viral infection

24
Q

Differentiation from bacterial and viral

A

Basis of S/S and changes in CSF

25
Q

Dx accuracy

A

Gram stain exam of CSF faster, less expensive and 90% accurate

26
Q

Open pressure - bacterial meningitis

A

200-500 mm H2)

27
Q

Normal open pressure

A

70-180

28
Q

Cell predominance

A

Neutrophils or lymphocytes

29
Q

To when actue bacterial suspected

A

Anti micro bias therapy. ASAP

Medical emergency, esp in children

30
Q

Dexamethasone

A

Can reduce subarachnoid inflammatory response, alleviate cerebral edema and vasculitis

31
Q

Death usually occurs

A

In the first two weeks

32
Q

Cranial nerve palsies

A

30% of the time —> hearing impairment

33
Q

Neuro complications

A

75% w/ bacterial

Impaired consciousness, seizures, focal neuro abnormalities

34
Q

Children can develop long term

A 
Hearing loss
Blindness
Developmental delay
Hydrocephalus 
Hypothalamic dysfunctions
Hemiparesis 
Quad/tetraparesis
35
Q

Mortality rate for tuberculous meningitis

A

20-50%

Neuro Anatomy (22 decks)

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