Meningeal syndrome: causes and pathogenesis
Last reviewed: 23.04.2024
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Causes and pathogenesis of meningeal syndrome
Meningitis. Depending on the etiology, meningitis is divided as follows.
- Bacterial (meningococcus, pneumococcus, hemophilic and tuberculosis bacillus, etc.).
- Viral (Coxsackie viruses, ECHO, mumps, etc.).
- Fungal (cryptococcosis, aspergillosis, candidiasis, etc.).
- Parasitic infections (cysticercosis, toxoplasmosis, amebiasis, etc.).
Primary meningitis - developing without previous signs of the pathological process, caused by the corresponding pathogen (eg, meningococcal), and secondary, in which the defeat of the membranes of the brain is preceded by other manifestations of generalized or local infection (for example, meningitis in epidemic parotitis, otogenic pneumococcal meningitis).
The causative agent of meningitis can enter the membranes of the brain with hematogenous (with meningococcal infection, sepsis, leptospirosis, etc.), lymphogenically and by direct spreading from purulent foci located on the head (otitis, mastoiditis, osteomyelitis, etc.).
In addition to inflammatory changes in the tissue of the meninges, meningitis is accompanied by excessive formation of the cerebrospinal fluid (leading to the development of intracranial hypertension) and an increase in the permeability of the blood-brain barrier. The spread of the inflammatory process to the walls of the ventricles leads to the development of ventriculitis, and directly to the substance of the brain - to purulent meningoencephalitis.
The toxic effect of the products of the vital activity of the pathogens of meningitis is accompanied by microcirculation disorders, cerebrospinal fluid disorders, resulting in the development of cerebral edema, its dislocation, the development of secondary stem syndrome, and the disruption of vital functions.
Subarachnoid hemorrhage. Spontaneous subarachnoid hemorrhage is most often caused by rupture of saccular aneurysm of arteries of the base of the brain. Much less often, its cause is arterio-venous malformations, mycotic aneurysms that result from infection of the vascular wall, exfoliating aneurysm of the vertebral or internal carotid artery.
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