This document discusses inflammatory conditions of the brain, specifically meningitis. It defines meningitis as an acute inflammation of the meningeal tissues surrounding the brain and spinal cord. The causes can be bacterial, viral, fungal, or due to other inflammatory diseases or cancers. Symptoms include fever, severe headache, nausea, photophobia, and decreased level of consciousness. Diagnosis involves lumbar puncture, CSF analysis, and tests for meningeal irritation. Treatment involves antibiotics, dexamethasone, osmotic diuretics, anticonvulsants, and IV fluids. Complications can include cranial nerve dysfunction, seizures, memory loss, and even death.

1. INFLAMMATORY
CONDITIONS OF
THE BRAIN

2. DEEPAK KRISHNA

4. Although meningitis is a
notifiable disease, the exact
incidence rate is unknown. It
can occur as a complication of
other disease and 50% is an
opportunistic infection.

5. Of newborns, 20–30% may die from
bacterial meningitis.
This risk is lower in older children.
Rises again in adulthood.
 In adults, 66% of all cases emerge
without disability. The main problems
are deafness (14%) and cognitive
impairment (10%)

6. Meningitis is an acute inflammation of
the meningeal tissues called
leptomeninges surrounding the brain
and the spinal cord.
Meningitis (from Greek word
méninx,"membrane”) is an acute
inflammation of the meninges ,caused
by either bacteria or virus.

7. The causes can be classified
into:
• Bacterial
Infections(streptococcus
pneumoniae, neisseria
meningitides)

8. • Viral Infections
• Fungal Infections
Inflammatory diseases (SLE)
• Cancer
Tuberculosis
• Trauma to head or spine

9. Systemic infections
Viral RTIs
Tobacco use
Impaired Immune system
Over crowding

10. Vaccinations
Seasonal: usually occurs in
the fall of winter or early
spring.

11. PATHOPHYSIOLOGY.

12. Enters the mucosal
surface/ cavity
Bacteria enters blood
stream/ trauma
Breakdown of normal
barriers

13. Crosses the blood
brain barrier
Proliferates in the CSF
Inflammation of the
meninges
ICP increases/
cerebral edema

14. Clinical manifestation
Fever
Severe headache
Nausea and vomiting
Photophobia
Decreased LOC
Increased ICP

15. Nuchal rigidity: It is an early
sign. any attempts at
flexion of the head are
difficult because of spasms
in the muscles of the neck.
Forceful flexion causes
severe pain.

16. Positive Kernig’s sign
 When the patient is lying with the
thigh flexed on the abdomen, the leg
cannot be completely extended.

17. Positive Brudzinski’s sign
 When the patient’s neck is flexed,
flexion of the knees and hips is
produced; when passive flexion of the
lower extremity of one side is made, a
similar movement is seen in the
opposite extremity

18. Brudzinski’s sign

19. If the infecting organism
is a meningococcus, a
skin rash is common and
petechiae may be seen.

20. Assessment and Diagnosis
History taking
Physical assessment
 CT and MRI
Blood culture and
sensitivity
Lumbar Puncture

21. Cont…
CSF analysis for protien,
glucose, WBC and gram stain
Meningeal stretch test (
Brudzinski’s test & Kernig’s
test)

22. complications
Cranial nerve dysfuction
Epilepsy/ seizures
Memory loss
Paralysis
Learning difficulty

23. Waterhouse
friderichsen syndrome
Complication of meningococcal
meningitis. It is manifested by
petechiae, disseminated
intravascular coagulation(DIC),
adrenal hemorrhage and circulatory
collapse.

24. DIC

25. Cont..
Behavioral difficulty
• Decreased intelligence
• Septicemia
• Death

26. Medical Management
 Bacterial meningitis:Third-generation
cefalosporin (eg: cefotaxime or
ceftriaxone)
 Ampicillin and penicillin
 Vancomycin is added in the regime in
case of resistance.
 Codeine for headache

27. Cont…
Dexamethasone
Acetaminophen or aspirin for
temparature above 100.4 F
Osmotic diuretics : Mannitol
Phenytoin IV for seizure
management.
IV fluid therapy

28. Non-pharmacological
management
Provide adequate bed rest.
Clear liquids as tolerated.
IV fluids to reduce dehydration
Isolate the patient
Elevate head of the bed 30
degrees and avoid neck flexion
and hip flexion.

29. Nursing diagnosis
 Ineffective cerebral tissue perfusion
related to increased ICP.
 Acute pain related to headache and
muscle aches.
 Hyperthermia related to infection and
abnormal temperature regulation by
hypothalamus from increased ICP.