Meninges diseases


Medical: Meninx encephali

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The Meninges can have various diseases. You can Inflammation and Bleeding develop or various neoplasms (Tumors) exhibit. Also the Meningeal irritation, which can lead to headaches and neck stiffness, is one of the diseases of the meninges.

Inflammation of the meninges (meningitis)

The Meningitis (meningitis) is the most well-known meningeal disease. It is caused by a wide variety of pathogens and can lead to serious and even fatal courses undetected. Meningitis symptoms are: headache, Neck stiffness, nausea and Vomit, such as dizziness. Mostly it works too fever associated with the symptoms.
Clinically, the doctor tests some specific ones "Meningism Sign". This is positive when the head can be turned passively, but not bent forward. You can still do that Laségue sign (Tension pain of the brain and spinal cord skin when lifting the extended leg while the patient is lying down), the Brudzinski neck mark (reflex-like flexion in the hip or knee joint when the head is passively bent forward) and the Kernig sign (The knee cannot be extended when the patient is seated; when the patient is lying down, the knee is reflexively bent when the extended leg is raised) testing. However, not all of these have to be positive to diagnose meningitis. Meningitis can be caused by both bacteria, as well as through Viruses caused.

Bacterial meningitis / purulent meningitis:
She can get through Meningococci, Pneumococci, Borellia and Haemophilus influenzae (especially in adults and children), E. coli, Listeria or Group B streptococci (especially in infants). Trigger can be a Infection of the paranasal sinuses, of Throat or the Gastrointestinal region be who then via the blood or the mucous membranes get to the meninges.
The Diagnosis is done by a CSF punctureat which something Nerve water taken from the spinal canal and examined in the laboratory. There the pathogens can then be detected by specific cultures and thus the right one antibiotic determine as therapy. This must be done as quickly as possible, as menigitis that is discovered too late or is untreated brain can also infect and it can lead to unconsciousness and circulatory collapse. Furthermore, the pathogens can spread to other organs via the blood and thus a sepsis (Blood poisoning) cause.

Viral meningitis
The viral meningeal diseases / meningitis can be caused by the following pathogens:

  • Acute form: Polio and coxsackie viruses, HIV, mumps- Cytomegaly-, Epstein-Barr-, Herpes- or Influenza-Viruses. Here the symptoms are usually less pronounced and the course is usually favorable, provided that the brain is not involved.
  • Chronic form: She is going through Tuberculosis pathogen initially triggered in other organs like the lung or the liver multiply and finally scatter over the blood into the meninges. They can be detected in the CSF and combated by a combination of four antibiotics. The therapy lasts about 1 year; the disease is fatal without it.

Fungal menigitis:
Meningitis caused by fungi almost only comes through with HIV infection or chemotherapy Immunocompromised patients. The most important representatives are the yeast fungus Candida albicans, Cryptococcus neoformans and the mold Aspergillus niger. The diagnosis is carried out by a CSF examination and the therapy over Antifungal drugs.

Meningeal tumors

The Meninges can also be different Tumors (Neoplasms, neoplasms) develop. This includes that Meningiomawhich is almost always benign. It is one Overgrowth of the hard meninges (Dura mater), which manifests itself mainly between the ages of 40 and 50. A meningioma grows the neighboring tissue displacing, however not infiltrating and because of its slow growth it is usually noticed relatively late. This is usually done on the basis of cerebral failure symptomssuch as the Loss of smell, hearing or taste, such as Paralysis of the muscles of the face or extremities or epileptic seizures. Therapy is not always necessary, depending on the severity of the symptoms Chemotherapy or radiation therapy.

Still there is malignant tumors of the meninges, like that malignant melanomathat can also occur here, meningeal sarcomas or Metastases of primary tumors of other organs. Also malignant lymphomas and Leukemias can manifest themselves in the meninges, so that for some forms a precautionary radiation of the skull is part of the therapy plan.

Meninges bleeding

Various vessels run between the meninges that can be injured by various causes and so close Bleeding to lead. Below is a brief overview of the different places where the bleeding can occur.

Epidural bleeding

This Bleeding often occurs through Rupture of a meningeal artery on what mostly by a trauma (accident) is triggered. The most common is Meningeal artery media affected. It creates a arterial hemorrhage between the periosteum of the skull and the dura mater. Here imagines Epidural spacewhich otherwise does not exist physiologically. The bleeding can cause compression of the brain tissue relatively quickly, often with the Symptoms of coma goes hand in hand. Furthermore you can unilateral paralysis on the opposite side of the bleeding form. An operative relief of the Intracranial pressure is the obligatory therapy here.

Subdural hematoma

A Subdural hematoma can be acute (mostly traumatic) occur or develop chronically over a long period of time. The bleeding takes place between the Dura mater and the Arachnoid and is through a Rupture of the bridge veins caused. This creates a subdural space that does not normally exist. The symptoms of the acute subdural hematoma is essentially the same as for epidural haemorrhage, a operative relief respectively. The chronic subdural bleeding symptoms can be creeping over weeks such as increasing dizziness, Headache and Clouding of consciousness cause. Therapeutically, a small hole is usually drilled into the skull to relieve pressure.

Subarachnoid hemorrhage

It arises from the Rupture of vessels or vascular malformations in the area of ​​the Basilar artery. This vessel is that main arterial trunk supplying blood to the brain and lies at the base of the skull. Here you can Vascular protuberances (Aneurysms), which eventually burst and lead to bleeding into the physiologically existing subarachnoid space. Due to the location of these vessels in close proximity to the brain stem, it can life-threatening disorders of vital functions how breathing and Cardiovascula come whose control centers are located there.
This area is difficult to reach operationally. Nevertheless, the operation is depending on the severity of the symptoms Therapy of choice, since vascular aneurisms should be rendered harmless to avoid the risk of Recurrent bleeding to minimize.
Diagnostic can be all types of intracerebral bleeding with the help of MRI of the brain or the Computed Tomography depict and differentiate.