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Kernig's Sign
Kernig's sign is a test used in physical examination to look for evidence of irritation of the meninges. The test involves flexing the thighs at the hip, and the knees, at 90 degree angles, and assessing whether subsequent extension of the knee is painful (leading to resistance), in which case it is deemed positive. This may indicate subarachnoid haemorrhage or meningitis. Patients may also show opisthotonus—spasm of the whole body that leads to legs and head being bent back and body bowed forward. Karl et al. noted much of the literature on Kernig's sign is old and they could find no randomised trials of it. They also noted low Sensitivity of 5% meaning absence of Kernig's sign does not rule out meningitis, specificity however is 95% so if positive then meningitis is very likely. Kernig's should not be relied on when meningitis is suspected and a Lumbar puncture should be performed. Name The test is named after Woldemar Kernig (1840–1917), a Russian neurologist. See also ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Meningism
Meningism is a set of symptoms similar to those of meningitis but not caused by meningitis. Whereas meningitis is inflammation of the meninges (membranes that cover the central nervous system), meningism is caused by nonmeningitic irritation of the meninges, usually associated with acute febrile illness, especially in children and adolescents. Meningism involves the triad (3-symptom syndrome) of nuchal rigidity (neck stiffness), photophobia (intolerance of bright light) and headache. It therefore requires differentiating from other CNS problems with similar symptoms, including meningitis and some types of intracranial hemorrhage. Related clinical signs include Kernig's sign and three signs all named Brudzinski's sign. Although nosologic coding systems, such as ICD-10 and MeSH, define meningism/meningismus as meningitis-like but in fact not meningitis, many physicians use the term ''meningism'' in a loose sense clinically to refer to any meningitis-like set of symptoms ''before ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Subarachnoid Haemorrhage
Subarachnoid hemorrhage (SAH) is bleeding Bleeding, hemorrhage, haemorrhage or blood loss, is blood escaping from the circulatory system from damaged blood vessels. Bleeding can occur internally, or externally either through a natural opening such as the mouth, nose, ear, urethra, vag ... into the subarachnoid space—the area between the arachnoid (brain), arachnoid membrane and the pia mater surrounding the human brain, brain. Symptoms may include a thunderclap headache, severe headache of rapid onset, vomiting, decreased level of consciousness, fever, and sometimes seizures. Neck stiffness or neck pain are also relatively common. In about a quarter of people a small bleed with resolving symptoms occurs within a month of a larger bleed. SAH may occur as a result of a head injury or spontaneously, usually from a ruptured cerebral aneurysm. Risk factors for spontaneous cases include high blood pressure, smoking, family history, alcoholism, and cocaine use. Generally, the d ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Meningitis
Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or altered consciousness, nausea, vomiting, and an inability to tolerate light or loud noises. Young children often exhibit only nonspecific symptoms, such as irritability, drowsiness, or poor feeding. A non-blanching rash (a rash that does not fade when a glass is rolled over it) may also be present. The inflammation may be caused by infection with viruses, bacteria or other microorganisms. Non-infectious causes include malignancy (cancer), subarachnoid haemorrhage, chronic inflammatory disease (sarcoidosis) and certain drugs. Meningitis can be life-threatening because of the inflammation's proximity to the brain and spinal cord; therefore, the condition is classified as a medical emergency. A lumbar puncture, in which a needle is inserte ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Opisthotonus
Opisthotonus or opisthotonos (from grc, ὄπισθεν, translit=opisthen, lit=behind and grc, τόνος, translit=tonos, lit=tension, label=none) is a state of severe hyperextension and spasticity in which an individual's head, neck and spinal column enter into a complete "bridging" or "arching" position. This extreme arched pose is an extrapyramidal effect and is caused by spasm of the axial muscles along the spinal column. It has been shown to occur naturally in birds, snakes suffering from advanced boid inclusion body disease, and placental mammals, among existing animals; it is observed in some articulated dinosaur fossils. Causes Opisthotonus is a symptom of some cases of severe cerebral palsy and traumatic brain injury or as a result of the severe muscular spasms associated with tetanus. It can be a feature of severe acute hydrocephalus, poisoning, and drowning. Infants Opisthotonus is more pronounced in infants. Opisthotonus in the neonate may be a symptom of mening ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Sensitivity And Specificity
''Sensitivity'' and ''specificity'' mathematically describe the accuracy of a test which reports the presence or absence of a condition. Individuals for which the condition is satisfied are considered "positive" and those for which it is not are considered "negative". *Sensitivity (true positive rate) refers to the probability of a positive test, conditioned on truly being positive. *Specificity (true negative rate) refers to the probability of a negative test, conditioned on truly being negative. If the true condition can not be known, a " gold standard test" is assumed to be correct. In a diagnostic test, sensitivity is a measure of how well a test can identify true positives and specificity is a measure of how well a test can identify true negatives. For all testing, both diagnostic and screening, there is usually a trade-off between sensitivity and specificity, such that higher sensitivities will mean lower specificities and vice versa. If the goal is to return the ratio at w ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Lumbar Puncture
Lumbar puncture (LP), also known as a spinal tap, is a medical procedure in which a needle is inserted into the spinal canal, most commonly to collect cerebrospinal fluid (CSF) for diagnostic testing. The main reason for a lumbar puncture is to help diagnose diseases of the central nervous system, including the brain and spine. Examples of these conditions include meningitis and subarachnoid hemorrhage. It may also be used therapeutically in some conditions. Increased intracranial pressure (pressure in the skull) is a contraindication, due to risk of brain matter being compressed and pushed toward the spine. Sometimes, lumbar puncture cannot be performed safely (for example due to a bleeding diathesis, severe bleeding tendency). It is regarded as a safe procedure, but post-dural-puncture headache is a common side effect if a small atraumatic needle is not used. The procedure is typically performed under local anesthesia using a aseptic technique, sterile technique. A hypodermic ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Woldemar Kernig
Woldemar Kernig, better known as Vladimir Mikhailovich Kernig ( lv, Voldemārs Kernigs; russian: Владимир Михайлович Керниг; 28 June 1840 – 18 April 1917) was a notable Russian and Baltic German internist and neurologist whose medical discoveries saved thousands of people with meningitis. He is best known for his pioneering work on diagnostics. Kernig's sign is named after him. Biography Woldemar Kernig was born in St. Petersburg in 1840 to a bookbinder of German origin, Benjamin Mikhail Kernig (1788-1862) and his spouse Wilhelmina Elizaveta (née Person). He received his early education at St. Peter's School from 1852 to 1856. In 1864, he graduated from Universität Dorpat with the degree of Doctor of Medicine for his dissertation about variations in body temperature in sick and healthy people (german: Experimentelle Beiträge zer Kenntniss der Wärmeregulirung beim Menschen). In the same year he began to work at Obukhovskaya Hospital in St. Peter ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
Brudziński's Sign
Brudziński's sign or a Brudziński sign is any of three medical signs, all of which may occur in meningitis or meningism. All three are named after Józef Brudziński. In English, the name is often written without the diacritic (like many borrowed words) (Brudzinski) and is pronounced . Brudziński cheek sign The Brudziński cheek sign or Brudziński's cheek phenomenon is a clinical sign in which pressure on the cheek elicits a reflex action, usually a twitching of the area near the eye or upper lip, and flexion of the forearm when pressure is applied to upper arm with a sphygmomanometer. It is found in patients with meningitis, and is analogous to the Brudziński symphyseal sign in the lower limb. Brudziński symphyseal sign The Brudziński symphyseal sign is a clinical sign in which pressure on the pubic symphysis elicits a reflex flexion of the hip and knee, and abduction of the leg. It is found in patients with meningitis, and is analogous to the Brudziński cheek sign in ... [...More Info...] [...Related Items...] OR: [Wikipedia] [Google] [Baidu] |
