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The aseptic meningitis syndrome: a complication of posterior fossa surgery
1Division of Pediatric Neurosurgery, Columbia Presbyterian Medical Center, New York, NY 10032.
Abstract:
The syndrome of aseptic meningitis is characterized by spiking fever and meningismus. CSF analysis generally shows increased pleocytosis, hypoglycorrhachia, elevated protein and negative cultures. In an earlier series, 70% of children with posterior fossa operations developed the syndrome. In a new review the incidence was slightly more than 30%. The incidence of aseptic meningitis following operation for structural lesions was 44%, which was higher than the tumor group, where the meningitic syndrome was seen in 25% of the children. It is the purpose of this paper to reexamine the impact that steroids have made on the prevalence of the aseptic meningitis syndrome, and to review recent studies that have attempted to distinguish between aseptic and bacterial meningitis.
Insights
Aseptic meningitis, characterized by fever and meningismus, is a complication following neurosurgery. Steroid use and lesion type impact its prevalence, necessitating differentiation from bacterial meningitis.
Area of Science:
- Neuroscience
- Infectious Diseases
- Pediatric Surgery
Background:
- Aseptic meningitis presents with fever and meningismus, showing specific cerebrospinal fluid (CSF) findings like pleocytosis and elevated protein.
- Historically, over 70% of children undergoing posterior fossa operations developed this syndrome.
Purpose of the Study:
- To reexamine the impact of steroid administration on the prevalence of aseptic meningitis.
- To review recent studies distinguishing aseptic meningitis from bacterial meningitis.
Main Methods:
- Review of clinical data and CSF analysis in patients with aseptic meningitis.
- Comparative analysis of aseptic meningitis incidence based on surgical indication (structural lesions vs. tumors) and steroid use.
Main Results:
- Current incidence of aseptic meningitis post-neurosurgery is over 30%, a decrease from earlier reports.
- Higher incidence (44%) observed after operations for structural lesions compared to tumors (25%).
Conclusions:
- Steroid impact on aseptic meningitis prevalence requires further investigation.
- Distinguishing aseptic from bacterial meningitis remains crucial for appropriate patient management.