Fever and a Stiff Neck: The Usual Suspect?
A 4-year-old girl is seen in the ED for low-grade fevers x2 weeks, headaches, neck stiffness. Lumbar puncture is recommended. Do you agree?
Conclusion Herpes encephalitis may rule your body but don't allow the infection to take over your brain. Herpes encephalitis is suppressible and so its symptoms if managed with great attention. Antiviral drugs such as Zovirax, acyclovir, Valacyclovir are some of the prominently used drugs in suppressing therapy of herpes infection. You are counseled to see your GP as soon as the very onset of any symptoms described above.You've read Cracking the Herpes Encephalitis Code | Causes, Symptoms and Treatment, originally posted on Pick the Brain | Motivation and Self Improvement. If you've enjoyed this, please visit our site f...
CONCLUSIONS: Only one out of every two patients meets the alarm criteria. The proportion of severe secondary headache is really low. The multidisciplinary management of headache needs to be improved in our setting to prevent people visiting the emergency department due to primary headaches without any alarm criteria. PMID: 31132134 [PubMed - in process]
CONCLUSIONS: Our two cases demonstrate that the listeriosis outbreak should change the way we view bacterial meningitis in SA: according to the National Institute for Communicable Diseases, empirical treatment for meningitis should include ampicillin and gentamicin in all adult patients with features of meningitis. There may be a need for an updated meningitis treatment guideline in SA. PMID: 31131793 [PubMed - in process]
We present a 48-year-old woman presenting with an inflammatory meningitis-like syndrome with headache and neck stiffness. Lumbar puncture was normal and computed tomography (CT) of the atlantoaxial joint showed abnormal calcifications around the odontoid process, leading to a tentative diagnosis of crowned dens syndrome. In addition, signs of active inflammation in and around the dens were present on cervical MR imaging. Since CDS can mimic meningitis or giant-cell arteritis, neurologists should be aware of this entity. If CDS is suspected, the bone window on the head CT scan can lead to the diagnosis. On the other hand, a...
Condition: Post-Lumbar Puncture Headache Interventions: Device: Sprotte 25G needle, stylet reinserted; Device: Sprotte 25G needle, stylet not reinserted; Device: Sprotte 22G needle, stylet reinserted; Device: Sprotte 22G needle, stylet not reinserted; Device: Spinocan 25G needle, stylet reinserted; Device: Sp inocan 25G needle, stylet not reinserted Sponsors: Jonatan Salzer; Umeå University Completed
ConclusionThe findings support the hypothesis that the elevation of intracranial pressure induces a microstructural compression of the optic nerve impairing axoplasmic flow and thereby causing the prelaminar papilledema. The microstructural compression of the optic nerve as well as the clinical symptoms improve within hours of normalization of intracranial pressure.
Conclusion: Accounting for brain volume derived from brain MRI is unlikely to improve the diagnostic value of protein concentrations in CSF. Introduction Cerebrospinal fluid (CSF) analysis is supportive of the diagnosis of many neurological diseases. CSF protein concentrations constitute a mainstay of CSF analysis. Despite age- and sex-dependent cut-offs (1–4), considerable interindividual variance may lower the diagnostic value of CSF protein concentrations. We aimed to reduce variance of CSF protein concentrations and, hence, to increase their diagnostic value by considering brain volumes derived from magne...