PREDISPOSING FACTORS

- Urti

- Otitismedia

- Mastoiditis

- Head trauma

- Invasive procedure

ETIOLOGY

-H.Influenza

-N. Meningitis

-S. Pneumonia

Inhalation of droplet nuclei

Goes in the respiratory tract

Respiratory infection

Escapes immune response

Crosses alveoli membrane

Septicemia

Reaches the meninges via the blood circulation

Inflammatory response Bacterial maturation

Release of chemical mediators Leukocytosis Release of Endotoxins

Kinins Histamines Leukocyte activity Meningeal nerve ending irritation

(Pyrogens) damaging

Formation of cycloxygenase

Thermoregulatory Vascular Exudates formation Spinal nerves

reset permeability Synthesis of prostaglandin

Cloudy CSF CSF viscosity Pain impulse - Joint pain

Hyperthermia fluid shifting - kernigs

Sluggish CSF formation Pain receptors - Brudzinkis

Cerebral edema - Nuchal

Absorption of CSF Headache rigidity

Vol. of CSF

Within cranial vault

ICP

Cerebral autoregulation

Compression vasoconstriction

Cerebral ischemia

Cerebral hermiation

Compression of brainstem

Respiratory center Vagal stimulation Thermoregulatory

Depression center impulse

errors

Brady N/V

Bradypnea Cardia

Hyper Hypo

Cardiac arrest thermia thermia

Respiratory arrest

Anaerobic

metabolism

Lactic acid Free radical

formation formation

Neural permeability Destruction Impaired of

Of protein Na-K pump

& cell wall

Rapid erratic Neural injury Depolarization failure

Impulse

Neurotransmitter

Failure

Disseminated

Cerebral errors motor cortex dizziness altered loc convulsion fixed weakness mental

confusion

Seizures abn motor respose Lethargy

Decorticate Decebrate Coma Death

Positioning positioning