Ammar Alnajjar

Signs of Meningeal Irritation

1- Neck stiffness
‫راسه يتحرك ى‬
Normally → ‫يمن و يرسى و حنجه يطخ بالصدر‬
‫ → اذا حنجه ما طخ بصدره و راسه ما تحرك ى‬this is rigidity (not significant as
‫يمن و يرسى‬
osteoarthritis or parkinson’s can cause this)
‫ى‬ ‫ى‬
‫ → اذا تحرك يمن و يرسى يس راسه ما تحرك لالمام ي‬positive neck stiffness
‫يعن ما طخ بصدره‬

2- Brudzinski sign
Severe neck stiffness causes a patient's hips and
knees to flex when the neck is flexed

3- Kernig's sign (must be bilaterally & positive if bilateral or unilateral)

a- Supine position
b- We do flexion of the hip and knee both 90 degree
c- We do leg extension (from knee) with one arm
and put the other arm on the hamstrings
And check the following:
1- Is there resistance at the knee ?
2- See patient face, if he’s hurting?
3- Check if there is spasms of the hamstrings?

Causes of meningeal irritation:

1- Meningitis (CNS infection)
2- Subarachnoid hemorrhage
3- Posterior cranial fossa tumor
Primitive Reflexes:

Indicates:
1- Frontal lobe lesion / Atrophy