Headache associated with central nervous system infection
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby in Headache in Clinical Practice, 2018
Meningitis refers to an infectious or inflammatoiy process of the meninges; we will consider infective causes (the inflammatory conditions have been dealt with in a previous chapter). Meningitis is classified according to the pathogen; it is most commonly viral or bacterial. Other infections are seen mainly in primary or secondary immune deficiency states. Bacterial meningitis was described by Vieusseaux and named ‘epidemic cerebrospinal fever’ after an outbreak in Switzerland in 1805. ‘Aseptic meningitis’, a term introduced by Wallgren in 1925, describes a benign and selflimited variant of meningitis that is usually due to a viral infection, with headache a prominent feature of the illness. Quinke, who is responsible for introducing the lumbar puncture in 1881, originally described viral meningitis and encephalitis in 1896.2 The annual incidence of acute bacterial meningitis in the United States is 5–10 cases per 100000 population.3,4 It occurs somewhat more frequently in men than in women.3–5 Children under the age of 5 years account for most cases, with the highest risk during infancy. Other predisposing factors are sickle cell disease, alcoholism, and AIDS and other immunocompromised states.
Neurological Disease in Herpes Simplex Virus Type 2 (HSV-2) Infection
Marie Studahl, Paola Cinque, Tomas Bergström in Herpes Simplex Viruses, 2017
Clinical symptoms of HSV-2-induced meningitis are mainly the same as those found in asentic meningitides caused by other viruses Headache, usually described as intense, develops during 2–3 days (10), together with varying degrees of other signs and symptoms of meningeal irritation such as neck stiffness, photophobia, nausea, and vomiting. Fever is common but not an obligatory finding [present in 63% of 71 patients in one study (14)]. In most cases, the acute symptoms of primary meningitis resolve spontaneously within a week, although sometimes only after a protracted illness (8,7,10,19,25). Neurasthenic symptoms such as mild headache, lability, concentration disabilities, and fatigue may, however, last for several weeks (8,22). One case of chronic meningitis with predominantly headache and meningism lasting for 4 weeks has been reported (35).
Postoperative pain
Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor in Manual of Neuroanesthesia, 2017
The brain is enclosed and protected by calvarium. The lower part of the skull is formed by the facial skeleton, which articulates with the mandible. The scalp is composed of five layers: skin, subcutaneous tissue, epicranium, subaponeurotic areolar tissue, and the pericranium. The interior of the cranium is lined with a fibrous membrane known as the endocranium. The endocranium forms the outer zone of the dura mater. It becomes continuous with the periosteum on the outer surface of the skull, which is called the pericranium. Three layers of meninges—the dura mater, the arachnoid, and the pia mater—enclose the brain. The scalp and the dura are innervated (Figure 29.1a and b) mainly by the following: The trigeminal nerve, and its three principal divisions (mandibular, maxillary, and ophthalmic) along with their branches.The upper three cervical nerves and the cervical sympathetic trunk.Minor branches from the vagus, hypoglossus, facial, and glossopharyngeal nerves.
An investigation of cerebral bridging veins rupture due to head trauma
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Hamed Abdi, Kamran Hassani, Shahrokh Shojaei
Global solid models include two models, the first model is of a healthy brain and the second one is of an atrophied brain. The components and thickness of each model are the same and include the scalp (5 mm), skull (7-8 mm), meningeal layers, and brain, respectively. However, the thickness of the meningeal layers is different. It is about 2.8 mm in the healthy model and about 6-7 mm in the atrophied model. These models are utilized to calculate stress, strain, and relative displacement of models between the brain and skull. The global models were validated by experimental data from Nahum et al. including two series of human head cadavers. Series I included 8 individual impact experiments on separate heads that measured the intracranial pressure. Series II presented successive impacts on a single sample (Nahum et al. 1977). After anthropometric measurements of different parts of the models, according to Table 1, we found that the healthy models were more consistent with case number 37 of Nahum's study and number 44 for the atrophied models.
Cerebrospinal fluid leaks secondary to dural tears: a review of etiology, clinical evaluation, and management
Published in International Journal of Neuroscience, 2021
Jason Gandhi, Andrew DiMatteo, Gunjan Joshi, Noel L. Smith, Sardar Ali Khan
The meninges are composed of three membrane structures that encapsulate the brain and spinal cord. The three membranes of the meninges from most superficial to deep are respectively the: dura, arachnoid, and pia mater. The dura mater is also referred to as the pachymeninx or “thick meninx”, while the pia and arachnoid mater collectively are referred to as the leptomeninx or “thin meninx” [5]. The dura itself is composed of three layers: the most superficial layer called the endosteal (i.e. periosteal), the meningeal layer, and the deepest layer called the dural border cell layer [6,7]. The dural border cell layer interacts with the arachnoid barrier cell layer and basement membrane of the arachnoid mater. It is in the arachnoid reticular layer and subarachnoid space that the CSF is contained. The depth of the subarachnoid space is variable depending on the relationship between the arachnoid and pia mater [7].
Inter-dural spinal cyst with acute thoracic compressive myelopathy: anatomical aspects of spinal dura, case report and literature review
Published in British Journal of Neurosurgery, 2020
Prajwal Ghimire, Andrea Perera, Jose Pedro Lavrador, Istvan Bodi, Jozef Jarosz, Gordan Grahovac, Keyoumars Ashkan
Spinal dura is formed from paraxial somatic mesoderm leading to formation of ectomeninx (the external layer of meninx primitiva).16 Microscopically, dura mater has 3 layers: an outermost loose fibroelastic layer; a middle fibrous layer and innermost cellular layer.16 It has been shown that the spinal dura mater represents the corresponding layer to the inner or meningeal layers of the cranial dura mater which becomes spinal dura at the foramen magnum.16 Spinal dura thickness is demonstrated to be highest at the thoracic spine and lowest in the lumbar spine in a cadaver study.17 Embryological studies have provided evidence that the adult dura mater, PLL and perichondrium develop from a ‘embryonic dura mater’ a cluster of mesenchymal cells dorsal to vertebral bodies and disc.6 There has been further descriptions of an ‘external spinal dura layer’, ‘inter-dural region’, ‘inter-dural plexus’ in the spine in the embryological studies that give us an insight to the development process of the spinal dura and the formation of ‘sinuous cranial inter-dural system’ and possibility of the continuation into the spine.6