Related Experiment Video
Updated: Jul 5, 2026
10:39
3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
Chronic daily headache: when to suspect meningitis.
Larry E Davis1, Joanna G Katzman
1Chief Neurology Service, New Mexico VA Health Care System, 1501 San Pedro Drive SE, Albuquerque, NM 87108, USA. LEDavis@unm.edu
Current Pain and Headache Reports
|April 18, 2008
Summary
Bacterial meningitis can be missed in emergency settings, leading to adverse outcomes. Early identification through careful history, physical exam, and cerebrospinal fluid (CSF) analysis is crucial for timely diagnosis and treatment.
Area of Science:
- Neurology
- Infectious Diseases
Background:
- Headaches are a common reason for medical visits, with primary headaches being most frequent.
- Serious secondary headaches, like meningitis, account for a significant percentage of emergency department visits for headache in children and adults.
- Bacterial meningitis can be initially overlooked by primary care and emergency physicians, delaying diagnosis and treatment.
Purpose of the Study:
- To highlight the importance of considering meningitis in headache differential diagnoses.
- To outline key historical and physical examination findings indicative of meningitis.
- To emphasize the diagnostic role of cerebrospinal fluid (CSF) analysis.
Main Methods:
- Review of clinical information obtainable from patient history and physical examination.
- Discussion of diagnostic criteria for meningitis.
- Guidance on interpreting cerebrospinal fluid (CSF) findings, particularly pleocytosis.
Main Results:
- Specific patient-reported symptoms and examination findings can suggest meningitis.
- Lumbar puncture with CSF examination is the definitive diagnostic test.
- CSF pleocytosis indicates inflammation and guides the differential diagnosis of meningitis types.
Conclusions:
- Prompt recognition of potential meningitis in patients presenting with headache is critical.
- A thorough clinical assessment combined with CSF analysis is essential for accurate and timely diagnosis.
- Early diagnosis of meningitis is vital to prevent severe consequences.
Related Concept Videos
01:22Bacterial Meningitis I: Introduction
Bacterial meningitis is a severe, life-threatening inflammation of the meninges, particularly the pia mater and arachnoid mater, affecting the subarachnoid space, ventricles, and cerebrospinal fluid (CSF). If untreated, it can lead to significant neurological complications or death.Causative AgentsCommon pathogens vary with age and immune status. In adults, major organisms include Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. Streptococcus agalactiae (group B...
01:24Bacterial Meningitis
Bacterial meningitis is a severe infectious disease involving inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. It occurs when pathogenic bacteria cross the blood–brain barrier and enter the cerebrospinal fluid. Common causative organisms include Neisseria meningitidis, Streptococcus pneumoniae, Haemophilus influenzae type b, Listeria monocytogenes, and Escherichia coli K1. The exact route of entry varies by pathogen and host condition.Routes of Entry...
01:18Viral Meningitis
Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
01:27Cryptococcal Meningitis
Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...
01:26Bacterial Meningitis II: Pathophysiology
Bacterial meningitis typically begins when pathogens such as Neisseria meningitidis and Streptococcus pneumoniae colonize the nasopharynx and invade the bloodstream. This process is facilitated by bacterial virulence factors, such as polysaccharide capsules, which resist phagocytosis and complement-mediated killing. Less commonly, bacteria reach the central nervous system via contiguous spread from infections like otitis media or sinusitis, through congenital or acquired dural defects, or...
01:19Encephalitis l: Introduction
Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...