Neurology-Online

Meningeal irritation

General

The Meninges surround the brain. You will be in the jargon Meninges called. There are three layers of the meninges. The innermost layer, the so-called soft meninges (Pia mater) lies directly on the brain and is, among other things, for the Supply of the cells responsible with nutrients. This is followed by the spider web skin (Arachnoid). Here it becomes Brain waterwhich surrounds the brain in small protuberances (arachnoid villi) forwarded to the blood. The outer hard meninges (Dura mater) serves to protect the brain.

In contrast to the brain itself, which is not sensitive to pain, the Meninges many pain receptors and are therefore very sensitive to pain. The Meninges can become irritated or inflamed which can be caused by various causes.

A Meningeal irritation is also known as Meningism or meningeal syndrome designated.

causes

Irritation of the meninges can be attributed to various causes. So can a Inflammation of the brain or des Backmarks pass to the meninges or bleeding through the brain increasing pressure in the skull a Meningeal irritation cause. Also Tumors or Metastases in different regions of the brain can have a Meningeal irritation trigger. .

Another cause are various diseases that are caused by bacteria or viruses. These irritate the meninges and in the worst case they lead to one Meningitis. These include, for example, syphilis or Herpes zoster (Shingles). Also the poliomyelitis can cause irritation as an accompanying symptom.

In addition, you can also Ulcers (Abscesses) of the spinal cord affect the meninges and irritate them. So can others Damage to the spine, especially in the neck area, affect the meninges and cause irritation there. Also a Sunstroke can be the cause of a Meningeal irritation be.

Symptoms

A Meningeal irritation mainly goes through severe pain when moving of the head noticeable. In particular, bending the head towards the chest is accompanied by severe pain. This symptom is called Meningism designated. Increased resistance is also noticeable with passive movements, for example by the doctor. This is also due to the pain that occurs. This can be explained by the fact that the Meninges in connection with the membranes of the spinal cord stand. If the head is bent, tension is created on the meninges and if they are irritated, it causes severe pain.

They also exist even without external influences a headache. Often it also occurs nausea and Vomit, Photosensitivity (Photophobia) and Sensitivity to noise (Phonophobia). All of these symptoms that usually occur with one Meningeal irritation appear together as meningeal irritation syndrome summarized. However, since these symptoms also occur with meningitis, an accurate diagnosis must be carried out.

The pain when bending the neck may also be associated with another condition. This is called a "pseudomeningism".

In addition, certain symptoms will occur when the doctor does various tests to determine the diagnosis. These include the so-called Brudzinski, Kernig and Laségue signs.

Symptoms in the child

At the Child may have meningeal irritation often bring completely different symptoms with them. In addition, they often cannot tell exactly what is hurting them. Finding a diagnosis is then often very difficult.

Often they are Headache less severe and the Neck stiffness is not as pronounced as it is in adults. Symptoms that can occur are decreased food intake or refusal to eat. Also Fatigue and weakness can occur. If fever occurs for no apparent cause, a pediatrician should be sought urgently as this may be a sign of Meningitis is.

In order to be able to classify the symptoms, special function tests can also be carried out on children.

diagnosis

If there is a suspicion of irritation of the meninges, the doctor will guide a few to make the diagnosis functional tests by. If these are “positive”, that is, if the patient reacts to them with a certain movement, this indicates an existing irritation.

When reviewing the Brudzinski's sign the patient lies on his back and the doctor moves his head towards the chest. If the reaction is positive, the patient will bend it Knee or hip joint to escape the pain. The Spinal membranes namely are relaxed by the flexion and so the tension on the meninges decreases.

The Kernig sign is positive if the patient cannot straighten the bent leg while lying on his back or feels severe pain.

The Laségue sign is considered abnormal if the patient is unable to bend the hip by about 70 to 80 ° due to pain.

Does the doctor provide one Meningeal irritation firmly, it is necessary to determine its cause. To do this, blood tests are done and imaging procedures such as magnetic resonance imaging (MRI) or one Computed Tomography (CT) performed. Also one Lumbar puncture about that Brain water investigation may be necessary.

treatment

Depending on what the Cause of meningeal irritation treatment is different.

If bacteria or other pathogens can be found, one must Antibiotic therapy be initiated. In these cases it is usually a Meningitis. Most of the time, care in the intensive care unit is necessary, as the disease can take a serious course.

Is there a Bleeding of the brain there is an urgent need for action. Surgery is usually needed to stop bleeding and relieve pressure on the meninges.

In the case of existing damage to the Cervical spinewhich is the cause of the meningeal irritation, appropriate measures must be taken to correct it. Often are physiotherapy and drugs for the pain of the treatment approach.
Even with severe ones Herniated discs of the cervical spine with a Meningeal irritation should physiotherapy and in the worst case, surgery is necessary.

Sun

The sun can also become one Meningeal irritation to lead. The meningeal irritation is a in this case Symptom of sunstroke. This happens when the affected person has been with for a long time uncovered head and neck stayed in the sun. The decisive factor for the resulting irritation is the heat of the sun's rays. In the worst case, the heat that builds up in the skull can also affect the brain. If the sunstroke is particularly pronounced, there is a risk that Brain edema, that is, a swelling of the brain.

A sunstroke becomes noticeable through you crimson head, Strength a headache and in some cases with neck stiffness. Also Dizziness, nausea and fatigue can occur in this context.

People with sparse hair or bald head are at increased risk of sunstroke. Older people and children are also at higher risk and should therefore protect their heads by covering them.

Is meningeal irritation contagious?

Depending on the cause of the Meningeal irritation triggered, it may or may not be contagious.

It is contagious in the context of a bacterial or viral meningitis.

However, it is through a Damage to the spine, one Sunstroke or a tumor triggered, there is no risk of infection.

homeopathy

To counteract headaches related to a Meningeal irritation there are different homeopathic options.

Against the severe headache becomes Belladonna used, with five globules in the power of C5 to be taken every hour. An alternative is Gelsemium sempervirens C15, of which five globules should be taken every two hours. At a later stage of the disease, when the symptoms are no longer as severe, the dose may be reduced.

To counteract photophobia, can Solanum nigrum C4 to C9 can be used.