General
The meninges surround the brain. They are called meninges in the technical language. There are three layers of the meninges.
The innermost layer, the so-called soft meninges (pia mater), lies directly next to the brain and is responsible, among other things, for supplying the cells with nutrients. This is followed by the spider web skin (arachnoidea). Here, the cerebral water surrounding the brain is passed on to the blood in small bulges (arachnoid villi).
The outer hard meninges (dura mater) serve to protect the brain. In contrast to the brain itself, which is not sensitive to pain, the meninges have many pain receptors and therefore react very sensitively to pain. The meninges can be irritated or inflamed, which can be caused by various factors. Irritation of the meninges is also known as meningismus or meningeal syndrome.
Causes
Irritation of the meninges can be due to various causes. For example, an inflammation of the brain or spinal cord can spread to the meninges, or a cerebral hemorrhage can cause an irritation of the meninges due to the increasing pressure in the skull. Tumors or metastases in different regions of the brain can also cause meningitis.
Another cause is various diseases caused by bacteria or viruses. These irritate the meninges and in the worst case they can lead to meningitis. These include syphilis or herpes zoster (shingles).
Polio can also cause the irritation as an accompanying symptom. In addition, ulcers (abscesses) of the spinal cord can also affect the meninges and irritate them. Other damage to the spinal column, especially in the neck area, can also affect the meninges and lead to a state of irritation. Sunstroke can also be the cause of meningitis.
Symptoms
Irritation of the meninges is mainly manifested by severe pain when the head is moved. Especially bending the head towards the chest is accompanied by strong pain. This symptom is called meningism.
Increased resistance is also noticeable during 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 are connected to the spinal meninges.
If the head is bent, the meninges become tense and if they are irritated, this causes severe pain. In addition, headaches exist even without external influences. Frequently there is also nausea and vomiting, sensitivity to light (photophobia) and noise (phonophobia).
All these symptoms, which usually occur together when the meninges are irritated, are summarized as meningeal irritation syndrome. However, since these symptoms also occur in meningitis, it is essential that a precise diagnosis is made. The pain when bending the neck can also occur in connection with another disease.
This is called “pseudomeningism”. In addition, certain symptoms occur when the doctor performs various tests to find a diagnosis. These include the so-called Brudzinski, Kernig and Laségue signs.
In children, meningitis can often cause completely different symptoms. In addition, they often cannot tell exactly what hurts them. It is then often very difficult to find a diagnosis.
Often the headaches are less severe and the neck stiffness is not as pronounced as in adults. Possible symptoms are a decrease in food intake or a refusal to eat. Fatigue and listlessness may also occur. If a fever occurs without an identifiable cause, a pediatrician should be consulted urgently, as this may be a sign of meningitis. To be able to classify the symptoms, special function tests can also be carried out on children.
