Synonyms
Medical: Meninx encephali
General information
The meninges can have different diseases. They can develop inflammations and bleedings or show different new formations (tumors). Irritation of the meninges, which can lead to headaches and neck stiffness, is also one of the diseases of the meninges.
Meningitis is the best known meningitis. It is caused by a variety of pathogens and can have severe, even fatal, courses if undetected. Symptoms of meningitis are Headache, stiffness of the neck, nausea and vomiting, and dizziness.
In most cases, fever is also associated with the symptoms. Clinically, the doctor tests some specific “meningismus signs”. This is positive if the head can be turned passively but cannot be bent forward.
Furthermore, one can test the Laségue sign (stretching pain of the cerebral and spinal cord skin when the stretched leg is lifted on the lying patient), the Brudzinski neck sign (reflex-like flexion in the hip or knee joint when the head is passively bent forward) and the Kernig sign (stretching of the knee is not possible in the sitting patient; when lying down, the knee is reflex-like bent when the stretched leg is lifted). However, these do not all have to be positive to diagnose meningitis. Meningitis can be caused by both bacteria and viruses.
Bacterial meningitisPurulent meningitis: It can be caused by meningococci, pneumococci, borellias and Haemophilus influenzae (especially in adults and children), E. coli, listeria or Group B Streptococci (especially in infants). The trigger can be an infection of the paranasal sinuses, throat or gastrointestinal region, which then reaches the meninges via the blood or mucous membranes. The diagnosis is made by means of a cerebrospinal fluid puncture, during which some cerebrospinal fluid is taken from the spinal canal and examined in the laboratory.
There, the pathogens can then be detected by specific cultures and thus the appropriate antibiotic as therapy can be determined. This must be done as quickly as possible, since menigitis discovered too late or untreated can also infect the brain, leading to unconsciousness and circulatory collapse. Furthermore, the pathogens can spread via the blood to other organs and thus cause sepsis (blood poisoning).
Viral Meningitis:The viral caused meningitis/ meningitis can be caused by the following pathogens: Fungal meningitis: Meningitis caused by fungi occurs almost exclusively in patients with immunodeficiency caused by HIV infection or chemotherapy. The most important representatives are the yeast fungus Candida albicans, Cryptococcus neoformans and the mold Aspergillus niger. Diagnosis is done by CSF examination and therapy with antimycotics.
- Acute form: Polio and Coxsackieviruses, HIV, mumps, cytomegalovirus, 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: It is triggered by tuberculosis pathogens, which first proliferate in other organs such as the lungs or liver and finally spread to the meninges via the blood. They can be detected in the cerebrospinal fluid and combated by a combination of four antibiotics. The therapy takes about 1 year; without it, the disease is fatal.
Various vessels run between the meninges, which can be injured by various causes and thus lead to bleeding. The following is a brief overview of the various places where bleeding can occur.