Main manifestations of meningeal irritation signs

The manifestations of meningeal irritation signs are neck stiffness, positive Kernig's sign, and positive Brudzinski's sign.

1. Neck Stiffness

Meningeal irritation is initially assessed through neck flexion testing. Patients may exhibit varying degrees of neck stiffness, encountering resistance when attempting to flex the neck. Passive movements in other directions may also be restricted. This symptom is commonly seen in conditions such as cervical spondylosis, meningitis, and subarachnoid hemorrhage.

2. Positive Kernig's Sign

When the patient lies supine with hips and knees flexed, if the angle between the thigh and lower leg fails to reach 135 degrees and the patient experiences pain or spasm of the hamstring muscles, the test is considered positive for Kernig's sign, suggesting possible involvement of lumbar spinal nerve roots.

3. Positive Brudzinski's Sign

The patient lies supine. The examiner supports the patient’s head with one hand and places the other hand on the patient’s chest to perform neck flexion. If passive neck flexion causes involuntary flexion of the knee and hip joints, and applying pressure to both sides of the face elicits bilateral upper limb abduction and elbow flexion, the test is positive for Brudzinski's sign.

When a patient exhibits these clear signs of meningeal irritation, prompt hospitalization and medical treatment are necessary to avoid delays in managing the underlying condition.