Bacterial spinal meningitis can cause symptoms such as seizures and coma as well as various complications, including brain damage, hearing loss, and learning disabilities. Furthermore bacterial spinal meningitis occurs in 4,100 people a year in the USA and approximately 500 people die.
Risk Factors of Bacterial Spinal Meningitis
- Age – Children under five, pregnant women, people between the ages 18-25 and people over 60 are at risk of bacterial spinal meningitis.
- People with transplants and on drugs that suppress the immune system are at risk of bacterial spinal meningitis.
- People with depressed immune systems from illness like cancer, HIV, sickle cell anemia and diabetes medications or surgical procedures are also at risk of bacterial spinal meningitis.
- Sinus, respiratory and ear infections or infections like these can worsen and turn into bacterial spinal meningitis.
- Working with or around meningitis causing bacteria can also place people in danger.
- People can be exposed to the disease that travel to the “meningitis belt” in sub-Saharan Africa in the dry season, or to Mecca during the Hajj and Umrah pilgrimage.
Dangers of ICP from Spinal Meningitis
As shown above the three stages of ICP can spiral down rapidly. The dangers of ICP Intracranial include seizures, stroke, brain damage and additionally even death. #SpinalMeningitis increases ICP Intracranial Pressure, from the swollen meninges and increased amount of CSF cerebrospinal fluid. Since bacterial spinal meningitis can cause a significant and rapid increase in both, it is important to monitor the ICP. The local hospital had no neurosurgeon and neurologist on staff to insert a device to monitor my ICP.
After two hours I lost consciousness and became comatose. The ICU doctors were concerned, because I thrashed, moaned and panted. A doctor prescribed Morphine, because they believed I was in pain. I stopped panting moaning and thrashing. So, they assumed (wrongly in my opinion) that I was better. A contraindication for Morphine is due to the fact it suppresses breathing. In short as I stopped panting and couldn’t blow off the CO2 and caused my ICP to surge.
EMERGENCY PATIENT ASSESSMENT ABC
- Check the patient’s consciousness.
- Check to make sure the patient’s airway is unobstructed and they can take a deep breath.
- Assess patient’s mental acuity. Can they speak in full and coherent sentences?
- Look, listen and feel for the movement of air
- Assess if the patient’s breathing process is sufficient in rate and volume passed?
- Assess if the patient struggles to breathe (patient effort versus effectiveness).
- Listen to the chest and assess the patient’s heart, lungs, and other organs and identify any differences from normal breathing. Normal breathing should sound like soft air movements; absent breath sounds is very bad; wheezes suggest broncho spasm; crackles and rales indicate pulmonary edema or infection.
- Examine for life- threatening hemorrhage
- Assess perfusion (level of consciousness, skin color, pulse rate and blood pressure
- Assess the pulse rate for regularity. What is the rate (15 seconds x 4), skin color, temperature, central and peripheral cap refill? (Perform the CRT Capillary Refill Test.)
In conclusion a neurosurgeon recognizes the signs of rising ICP. Incubation would have secured my airway and ability to breathe. (I am not a medical professional, however a patient with any condition that involves brain swelling is treated in a tertiary hospital,because they have neurologists and neurosurgeons on staff. Instead I had a brain stem stroke infarct, herniation and pulmonary arrest.
Possible Long term Complications of Bacterial Spinal Meningitis
- Brain damage of varying degrees
- Seizures (I have had two caused from drug reactions eighteen years apart.)
- Hearing loss (I am deaf in my left ear.)
- Hydrocephalus is a condition that accumulates and grows and results in brain swelling. (The VP shunt prevents the buildup of fluid in my head.)
- Subdural effusion (Since I no longer have infected meninges, I think that complication was removed.)
SUPPLEMENTARY INFORMATION LINKS
- Bacterial Meningitis and ICP Intracranial Pressure
- Blood-Brain Barrier
- Cerebral Perfusion Pressure CPP
- Mean Arterial Pressure
- ICP in comatose patients
- Control of Intracranial Hypertension
See Part 1 Bacterial Pneumococcal Spinal Meningitis or next week’s blog post for information on brain stem stroke, infarct and herniation and coma.