Eng / Meningeal syndrome
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With lumbar puncture
the liquid usually flows out under pressure. It is especially high in some viral serous meningitis, while in purulent meningitis, the pressure in some cases increases moderately.
The characteristic of liquor is normal
Color - clear CSF
Pressure -120-180 mm water column
Protein –0.1-0.3g/l
Cytosis - 4-6 cells in 1 µl of CSF
Composition of cells - 100% lymphocytes
Glucose - 2.2-3.3 mmol / l
Lactate -1.2-2.2 mmol / l
pH -7.35-7.40
Chlorides - 115-125 mmol/l
Liquor research
The detection of pleocytosis indicates meningitis, regardless of the presence and severity of the meningeal syndrome.
Uniform staining of the cerebrospinal fluid with blood indicates a subarachnoid hemorrhage or breakthrough of blood into spaces containing cerebrospinal fluid.
Liquor for meningitis
Globulin reactions (Pandi, Nonne - Apelt) in all forms of purulent meningitis are sharply positive.
The sugar content in the cerebrospinal fluid is markedly reduced with purulent
remains normal or elevated in viral serous meningitis.
MENINGISM - the presence of meningeal symptoms in a number of common infectious diseases
•The idea of a slight severity of meningeal syndrome in meningism is not true
•Often, the meningeal symptom complex dominates the picture of the disease, obscuring the manifestations of the underlying disease, and then
•of decisive importance belongs to the study of cerebrospinal fluid.
Liquor for purulent meningitis
the protein content in the cerebrospinal fluid often varies within 0.65-1.2
in older children, low protein content due to hyperproduction of cerebrospinal fluid
in young children, there is lower intracranial hypertension due to intense fluid resorption in parallel with greater vascular permeability.
What determines in the acute period of the disease a more pronounced edema of the medulla itself, and the occurrence of a convulsive syndrome.
Cellular composition of cerebrospinal fluid in purulent meningitis
in the acute period - pleocytosis, reaching several thousand or more cells per 1 mm3 by the 2-3rd day of illness (mainly polynuclear cells).
With a favorable course of the disease, the number of cellular elements decreases, the relative content of lymphocytes increases,
while neutrophilia decreases.
The content of chlorides in the cerebrospinal fluid
remains unchanged (115-125 mmol/l)
A decrease in the level of chlorides can be in patients with severe and moderate forms of the disease.
the level of chlorides is below normal - pathognomonic for tuberculous meningitis.,
Classification of meningitis According to the mechanism of occurrence
Primary
Secondary