UNIT 7
NUR 265 NEUROLOGICAL
DISORDERS
INTRACRANIAL INFECTIONS
MENINGITIS
INTRODUCTION
Meninges
3 covering connective tissue layers of brain and spinal cord: Meninges (form the
blood-brain barrier).
the pia mater (closest to the CNS)
the arachnoid mater
the dura mater (farthest from the CNS).
The meninges contain cerebrospinal fluid (CSF).
DEFINITION
Meningitis is inflammation of the meninges due to various causes that may be
infectious or non-infectious.
Common cause: Bacterial and viral infection in the ears, sinuses, or upper
respiratory tract.
Other causes: Fungal, irritation, subarachnoid haemorrhage, cancer, autoimmune
disorders, and medications.
Contagious
Mode of transmission: coughing and sneezing and through close contact.
Involvement of dura mater: pachymeningitis
Involvement of pia and arachnoid: leptomeningitis
TYPES OF MENINGITIS
A. Infectious: bacteria, virus, fungi and parasites
B. Non-infectious
,A. Infectious Meningitis
1. Bacterial meningitis or pyogenic meningitis
Extremely serious illness (medical emergency) which requires immediate
diagnosis and immediate treatment.
If not treated quickly, it can lead to death within hours -- or lead to
permanent damage to the brain and other parts of the body.
Caused by pus- forming bacteria, especially the meningococcus (children and
young adults), pneumococcus (children and adults). and haemophilus organisms
(infants and young children until the Hib vaccine was introduced for infants).
, 2. Viral Meningitis
Also called acute benign lymphocytic and acute aseptic meningitis.
more common than bacterial form
involves all age groups, but children are most often affected.
generally -- but not always -- less serious.
are much less likely to have permanent brain damage after the infection resolves.
Most will recover completely.
Prolonged fever and seizures in severe case
E.g. Herpes Simplex virus, Varicella Zoster virus, Mumps virus and HIV, Coxsackie
virus, Poliovirus, Hepatitis A, Herpes virus
3. Fungal Meningitis
much less common or rare in healthy people.
Person with impaired immune system such as AIDS is more likely to become
infected.
Some common form of fungi are; Cryptococcosis, Candidiasis and Aspergillosis.
4. Tubercular meningitis:
Occurs via hematogenous spread from a primary focus.
Subarachnoid space contains thick and basal exudates.
Tuberculous meningitis must be considered, especially in person traveling or
living, and in immigrants from developing countries.
Is a serious complication of childhood tuberculosis.
more common to be disseminated in very young or immuno suppressed patient.
caused by “Tuberculin bacillus.”
B. Non-infectious Meningitis
Malignant conditions:
Neoplastic meningitis is seen among 3 to 8% of the patient with cancer.
Spread of cancer to the meninges,
Inflammatory conditions like sarcoidosis, connective tissue disorder;
NUR 265 NEUROLOGICAL
DISORDERS
INTRACRANIAL INFECTIONS
MENINGITIS
INTRODUCTION
Meninges
3 covering connective tissue layers of brain and spinal cord: Meninges (form the
blood-brain barrier).
the pia mater (closest to the CNS)
the arachnoid mater
the dura mater (farthest from the CNS).
The meninges contain cerebrospinal fluid (CSF).
DEFINITION
Meningitis is inflammation of the meninges due to various causes that may be
infectious or non-infectious.
Common cause: Bacterial and viral infection in the ears, sinuses, or upper
respiratory tract.
Other causes: Fungal, irritation, subarachnoid haemorrhage, cancer, autoimmune
disorders, and medications.
Contagious
Mode of transmission: coughing and sneezing and through close contact.
Involvement of dura mater: pachymeningitis
Involvement of pia and arachnoid: leptomeningitis
TYPES OF MENINGITIS
A. Infectious: bacteria, virus, fungi and parasites
B. Non-infectious
,A. Infectious Meningitis
1. Bacterial meningitis or pyogenic meningitis
Extremely serious illness (medical emergency) which requires immediate
diagnosis and immediate treatment.
If not treated quickly, it can lead to death within hours -- or lead to
permanent damage to the brain and other parts of the body.
Caused by pus- forming bacteria, especially the meningococcus (children and
young adults), pneumococcus (children and adults). and haemophilus organisms
(infants and young children until the Hib vaccine was introduced for infants).
, 2. Viral Meningitis
Also called acute benign lymphocytic and acute aseptic meningitis.
more common than bacterial form
involves all age groups, but children are most often affected.
generally -- but not always -- less serious.
are much less likely to have permanent brain damage after the infection resolves.
Most will recover completely.
Prolonged fever and seizures in severe case
E.g. Herpes Simplex virus, Varicella Zoster virus, Mumps virus and HIV, Coxsackie
virus, Poliovirus, Hepatitis A, Herpes virus
3. Fungal Meningitis
much less common or rare in healthy people.
Person with impaired immune system such as AIDS is more likely to become
infected.
Some common form of fungi are; Cryptococcosis, Candidiasis and Aspergillosis.
4. Tubercular meningitis:
Occurs via hematogenous spread from a primary focus.
Subarachnoid space contains thick and basal exudates.
Tuberculous meningitis must be considered, especially in person traveling or
living, and in immigrants from developing countries.
Is a serious complication of childhood tuberculosis.
more common to be disseminated in very young or immuno suppressed patient.
caused by “Tuberculin bacillus.”
B. Non-infectious Meningitis
Malignant conditions:
Neoplastic meningitis is seen among 3 to 8% of the patient with cancer.
Spread of cancer to the meninges,
Inflammatory conditions like sarcoidosis, connective tissue disorder;
