Neck stiffness

Introduction

Introduction

Neck stiffness is an important objective sign in meningeal irritation. It is mainly characterized by different degrees of muscle rigidity, especially extensor muscles. The head flexion is obviously restricted, that is, the passive flexion neck encounters resistance, and the head side bend is also limited. The head rotation movement is limited to light, and the head back is not strong. Found in various types of meningitis, subarachnoid hemorrhage, increased intracranial pressure, cervical disease and so on.

Pathogen

Cause

1. Bacterial meningitis is caused by a certain bacterial infection. There are three types, namely Haemophilus influenzae type B, Neisseria meningitidis (diseococcus) and Streptococcus pneumoniae (Pneumococci). About 80% of the United States is bacterial meningitis. Usually a small group of healthy people carrying these germs in the nose or on the body does not invade the human body. He spreads through coughing or sneezing. Some studies have shown that people are most likely to be infected by germs when they have a cold, because it is extremely easy to get bacteria into the skull because of the inflammation of the nose.

2. Tuberculous meningitis is a non-suppurative inflammation of the meninges caused by Mycobacterium tuberculosis, accounting for about 6% of systemic tuberculosis. Mycobacterium tuberculosis infection is disseminated by blood and then implanted under the pia mater to form tuberculous nodules. After nodule rupture, a large number of tuberculosis bacteria enter the subarachnoid space. In recent years, the incidence and mortality of tuberculous meningitis have increased. Early diagnosis and treatment can improve efficacy and reduce mortality.

3. Viral meningitis can be caused by several viruses, including several viruses associated with diarrhea, one of which may be infected by bites such as the voles.

4. Cryptococcal meningitis: can also be caused by fungi. The most common one is cryptococcus, which can be found in pigeons. Healthy people are not susceptible to fungal-associated meningitis, but different from those infected with HIV, a human immunodeficiency virus that causes AIDS.

Examine

an examination

Related inspection

Neck MRI examination neck activity test neck test

According to the history of otitis media and signs of meningitis and lumbar puncture, the general diagnosis is not difficult. In recent years, due to the wide application of broad-spectrum antibiotics, acute conditions are mostly inhibited, cerebrospinal fluid chemical changes are not large, protein may increase slightly, sugar and oxides may be in the normal range, white blood cells are slightly increased, especially improper treatment, may evolve It becomes a focal or protracted meningitis that is easily confused with mild tuberculous meningitis or epidemic cerebrospinal meningitis.

Diagnosis

Differential diagnosis

The neck is stiff: the neck, shoulders and occipital pain, accompanied by the corresponding tender points and the neck is stiff, which is the clinical feature of cervical spondylosis. Cervical cervical spondylosis is very common in clinical practice, and it is the earliest cervical spondylosis, and it is also a common early manifestation of other types of cervical spondylosis. It is mainly called local type. Because the symptoms are mild, often paying insufficient attention, resulting in repeated attacks and aggravating the disease, many patients with repeated stiffening are mostly of this type. In the past, many people did not recognize this type. Therefore, there are few mentioned in the literature. Cervical cervical spondylosis, also known as ligamentous joint capsule cervical spondylosis, is often referred to as "slipping pillow" in acute attacks. This type of cervical spondylosis is mostly due to the inappropriate height of the pillow or the improper sleeping position during sleep. The cervical vertebra rotates beyond its own movable limit, or because the cervical vertebra bends for a long time, part of the intervertebral disc tissue gradually moves to the extension side, stimulating the nerve root and causing pain. . "Sillow pillow" does not exclude non-cervical factors. If the neck of the femur is cold, rheumatoid myositis, back muscle strain or sudden neck torsion, etc., can also lead to "pillow" symptoms. This type is actually the early stage of various types of cervical spondylosis. Most of them are at the beginning of cervical vertebrae degeneration, and cause cervical symptoms through sinus nerve reflex. However, if not handled properly, it is easy to develop into other more serious types.

Neck stiffness: neck stiffness refers to neck muscle tension, bloating, hard, sputum (cramping) and other phenomena, neck movement is not flexible. Common in fatigue, cervical spondylosis. Neck stiffness is a persistent over-contraction of the muscles, which not only reduces the blood supply to the neck muscles, but also causes the accumulation of metabolites such as lactic acid, which causes muscle ischemic pain. Back pain and head pain may be tension headaches caused by head or cervical lesions. Cervical spondylosis, also known as cervical vertebra syndrome, is a general term for cervical osteoarthritis, proliferative cervical spondylitis, cervical nerve root syndrome, and cervical disc herniation. It is a disease based on degenerative pathological changes. Mainly due to long-term cervical vertebrae strain, bone hyperplasia, or disc herniation, ligament thickening, resulting in cervical spinal cord, nerve root or vertebral artery compression, a series of clinical syndromes of dysfunction. The manifestations of cervical disc degeneration and its secondary pathological changes, such as vertebral instability, loosening; nucleus protruding or prolapse; spur formation; ligament hypertrophy and secondary spinal stenosis, etc., stimulated or oppressed Adjacent nerve roots, spinal cord, vertebral artery, and cervical sympathetic nerves, and cause a variety of symptoms and signs of the syndrome.

Neck stiffness: neck activity is limited, this symptom can be seen in the neck rib syndrome. Cervical rib syndrome is a complex clinical syndrome caused by vascular nerve compression in the thoracic exit area. It is also known as cervical thoracic outlet syndrome, anterior scalene syndrome, pectoralis minor muscle syndrome, rib lock syndrome, and excessive abduction. Syndrome, etc., refers to a series of upper extremity blood vessels and neurological symptoms caused by compression of brachial plexus and subclavian arteries and veins for some reason. Clinically, the main manifestations are pain, numbness of the shoulders, arms and hands, and even muscle weakness, weakness of the hands, cold and purple, and weakening of the iliac artery.

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