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KMID : 0371619980140010081
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Journal of Wonkwang Medical Science
1998 Volume.14 No. 1 p.81 ~ p.86
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The Charactersistics of Headache in Patients with Aseptic Meningtis
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Chang Hyuk
Kim Yo-Sik
Cho Kwang-Ho
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Abstract
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Background : The headache of aseptic meningitis is poorly described.. In an attempt to better s delineate it, we undertook a retrospective analysis of adult patients with aseptic meningitis to determine what features of headache and what associated symptoms or signs correlate with the diagnosis.
Method : We reviewed 188 patients with cerebrospinal fluid confirmation of aseptic meningitis (increased protein; increased white blood cell count; negative gram stain; and negative fungal, tuberculosis, and bacterial culture), which occurred in clusters from May through October, 1997. We analysis characteristics of headache, CSF findings, CT findings and associated clinical symptoms.
Results : All the patients had headache, which was typically severe and bilateral(186 of 188). The headache was abrupt in onset or abruptly worsened in 135 of the patients. The quality of the headache was usually bursting(158 of 188). Most had one or more associated symptoms, including fever(94.7%), nausea(80.9%), vomiting(68.1%), stiff neck(29.0%), myalgia(11.8%), diarrhea(8.6%), back pain(3.7%) and numbness on extremities(0.5%). CSF was abnormal in all the patients; all had a pleocytosis, 99 patients had an initial lymphocytic predominance. The CSF protein ranged from normal to moderately elevated and the CSF glucose approximated two thirds that of serum glucose.
Conclusion : Febrile headache patients should be taken a lumbar puncture if no systemic cause of their fever was found. In nonfebrile patients, clues to the diagnosis of meningitis included an abrupt or severe headache, or meningeal signs.
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KEYWORD
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Aseptic meningtis, Headache Lumbar puncture
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