traumatic meningitis
Introduction
Introduction to traumatic meningitis Traumatic meningitis is more common in patients with open craniocerebral injury, firearm injury and skull base fracture, often associated with wound treatment too late, debridement is not complete. Mostly diffuse suppurative meningitis, caused by bacteria invading the subarachnoid space. Pathogenic bacteria are often Staphylococcus, Streptococcus and the like. basic knowledge The proportion of illness: 0.02% Susceptible people: no special people Mode of infection: non-infectious Complications: brain abscess hydrocephalus swelling
Cause
Causes of traumatic meningitis
(1) Causes of the disease
Meningitis caused by craniocerebral injury is more common in patients with skull base fractures with cerebrospinal fluid leakage, or due to penetrating penetrating open wounds, but if the latter is properly treated early, the chance of meningitis is better than expected. Much less, the path of purulent bacteria into the subarachnoid space can be accessed from the blood, respiratory tract, paranasal sinus, middle ear and mastoid areas, or even the sella, in addition to the open wound.
(two) pathogenesis
The pathogens are usually Staphylococcus, Streptococcus, Gram-negative bacilli or anaerobic bacteria, but the sinusoidal sinus and the sinus sinus into the cranial meningitis are more pneumococcal, and the penetrating brain injury Late meningitis, often caused by deep brain infections invading the ventricular system or due to rupture of abscesses, occurs once the infection occurs, due to bacterial toxins and inflammatory reactions in the subarachnoid space, resulting in cerebral edema, increased intracranial pressure and cerebral blood Flow barriers.
Prevention
Traumatic meningitis prevention
Timely surgical debridement, effective control of scalp and skull infection, patients with cerebrospinal fluid leakage should be treated promptly.
Complication
Traumatic meningitis complications Complications, brain abscess, hydrocephalus swelling
Traumatic meningitis often causes serious complications and sequelae if not treated promptly, such as brain abscess, hydrocephalus, brain swelling, subdural empyema and cerebrovascular damage.
Symptom
Traumatic meningitis symptoms Common symptoms Brain parenchymal infiltration encephalitis-like changes High fever nausea convulsions Intracranial infection Consciousness disorders Increased intracranial pressure Meningitis
In the early stage after injury, there is often moderate fever caused by traumatic reaction. For example, after 3 to 4 days of hypothermia, hyperthermia occurs again, or body temperature does not decrease but rises, accompanied by headache, nausea, vomiting, chills, pulse rate and Consciousness disorder, even convulsions and convulsions, examination of meningeal irritation, manifested as neck stiffness, Klinefelter and Bruce's sign positive, but there are also a few meningitis patients with insidious attacks, such as cerebrospinal fluid leakage caused by secondary intracranial infection There may be no obvious discomfort 1 to 2 days after the rickets, and meningitis in the late stage of penetrating penetrating injury often has cerebral edema, increased intracranial pressure and cerebral blood flow disorder.
Examine
Traumatic meningitis
Blood routine
It can show a significant increase in peripheral blood leukocytes.
2. Lumbar puncture
Cerebrospinal fluid pressure is normal or slightly higher, the appearance is turbid, the number of white blood cells is significantly increased, mostly multinucleated cells, the sugar content is reduced, the protein content is increased, and the bacterial culture can be positive.
In general, there are no abnormal findings in CT scans. In severe cases, the basal cerebral cistern of the brain can be seen. The cerebral longitudinal fissure pool has high density shadow and choroid plexus density increase. When encephalitis occurs, there is a localized or diffuse low-density area in the brain parenchyma. The symmetry is reduced, and when the scan is enhanced, the pia mater and the cerebral cortex are thinned or have cerebral palpebral strengthening. When meningitis is accompanied by brain abscess, hydrocephalus, subdural empyema, and ventriculitis, CT More helpful for diagnosis.
Diagnosis
Diagnosis and diagnosis of traumatic meningitis
For patients with suspected meningitis, early stage of lumbar puncture should be used for cerebrospinal fluid examination, timely diagnosis, according to the history of head trauma, clinical manifestations and cerebrospinal fluid examination results can be clearly diagnosed, CT scan can help to identify the cause of infection, Further determine the treatment plan.
