A child with a stiff neck

Anatomy
1. Skull
2. Meninges
  1. CSF
    1. Secretion
      1. From the choroid plexus, which are found on the lateral ventricles, roof of the 3rd ventricle, and the 4th ventricle
    2. Absorption
      1. Absorbed from the superior sagittal sinus through the arachnoid villi
    3. Circulation
      1. Through the ventricular system
3. Ventricular system
  1. Lateral ventricles
    1. 3rd ventricle
      1. 4th ventricle
  2. Foramen of Monro
    1. Cerebral Aqueduct
      1. Central canal
Meningitis
1. Inflammation of the protective membranes covering the brain and spinal cord (meninges)
2. Causes
  1. Infectious
    1. Viral
      1. Bacterial
        Neisseria Meningitidis
        Listeria monocytogens
        H.Influenza
        Streptococcus agalactiae
      2. Enterovirus
        Cocxakie virus
        Echovirus
    2. Fungal
      1. Cryptococcus newformans
  2. Non-infectious
    1. injury (head trauma), drugs and cancer
  3. Signs and symptoms
    1. Fever
      1. Headache
        Neck stiffness
        Photophobia
    2. Pathology
      1. 1. penetrate the blood-brain barrier
        2. endotoxin and inflammatory mediators
        3. leakage of protein and fluid out of the cerebral vasculature
        4. causing cerebral edema , increase intracranial pressure
        5. lead to a reduction in cerebral perfusion
        6. Brain death
    3. Investigations
      1. Lumbar Puncture
        Insertion of needle in subarachnoid space at levels
        In Infants: L4-L5 interspace
        In Adults: L3-L4 interspace
        Indications
        Diagnostic
        Therapeutic
        Anesthesia
        Injection of Drug (Antibiotic, Chemotherapy)
        Sample CSF (Infections, Cancers, Subarachnoid Hemorrhage, Neurologic Disorders)
        Measure pressure
        Contra-indications
        Increased intracranial pressure
        Infections at the level of insertion
        Uncorrected Coagulopathy
        Complications
        Severe headache
        Hemorrhage
        Back pain
      2. Physical examinations
        Vital signs
        Meningeal signs
        General inspection
        Neurological examinations
        Kernig's sign
        Brudzinski's sign
        Management
        Newborn
        Adult
        Elderly
        Ampicillin + vancomycin + 3rd generation cephalosporin
        Vancomycin + 3rd generation cephalosporins
        Ampicillin + 3rd generation cephalosporin + Aminoglycoside

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A child with a stiff neck

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	Creado por fatima alkhateeb hace casi 6 años