Brudziński's sign or a Brudziński sign is any of three

medical sign Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

s, all of which may occur in

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, intense headache, vomiting and neck stiffness and occasion ...

or meningism. All three are named after

Józef Brudziński Józef Polikarp Brudziński (26 January 1874 – 18 December 1917) was a Polish pediatrician born in the village of Bolewo (now in Mława County). Biography He studied medicine in Tartu and Moscow, and in 1897 moved to Kraków, where he trained ...

. 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 Signs and symptoms are diagnostic indications of an illness, injury, or condition. Signs are objective and externally observable; symptoms are a person's reported subjective experiences. A sign for example may be a higher or lower temperature ...

in which pressure on the cheek elicits a reflex action, usually a twitching of the area near the eye or upper lip, and

flexion Motion, the process of movement, is described using specific anatomical terminology, anatomical terms. Motion includes movement of Organ (anatomy), organs, joints, Limb (anatomy), limbs, and specific sections of the body. The terminology used de ...

of the

forearm The forearm is the region of the upper limb between the elbow and the wrist. The term forearm is used in anatomy to distinguish it from the arm, a word which is used to describe the entire appendage of the upper limb, but which in anatomy, techn ...

when pressure is applied to upper arm with a sphygmomanometer. It is found in patients with

, and is analogous to the Brudziński symphyseal sign in the lower limb.

Brudziński symphyseal sign

The Brudziński symphyseal sign is a

in which pressure on the

pubic symphysis The pubic symphysis (: symphyses) is a secondary cartilaginous joint between the left and right superior rami of the pubis of the hip bones. It is in front of and below the urinary bladder. In males, the suspensory ligament of the penis attache ...

elicits a reflex

of the hip and knee, and abduction of the leg. It is found in patients with

, and is analogous to the Brudziński cheek sign in the upper limb. This sign was also independently discovered by a Brazilian clinician, Aloísio De Castro (1881-1959), in 1912, and is commonly called Aloísio De Castro's Sign in Brazil.

Brudziński neck sign

The Brudziński neck sign or Brudziński's symptom is a

in which forced

of the neck elicits a reflex flexion of the hips. It is found in patients with

subarachnoid haemorrhage Subarachnoid hemorrhage (SAH) is bleeding into the subarachnoid space—the area between the arachnoid membrane and the pia mater surrounding the brain. Symptoms may include a severe headache of rapid onset, vomiting, decreased level of c ...

and possibly

encephalitis Encephalitis is inflammation of the Human brain, brain. The severity can be variable with symptoms including reduction or alteration in consciousness, aphasia, headache, fever, confusion, a stiff neck, and vomiting. Complications may include se ...

. It is not very commonly seen.

Pathophysiology

The pain felt on Kernig's sign is due to meningeal irritation caused by movement of the

spinal cord The spinal cord is a long, thin, tubular structure made up of nervous tissue that extends from the medulla oblongata in the lower brainstem to the lumbar region of the vertebral column (backbone) of vertebrate animals. The center of the spinal c ...

within the meninges. In the Brudzinski's neck sign, this movement with neck flexion is cancelled out by the flexion of the hip; much like two persons pulling on either side of a single rope.

References

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