Besides regular stress-related headaches and migraines, another kind of headache is meningismus. The meninges is the fibrous tissue layer that covers the brain and spinal cord. This serves to protect these vital body parts, and when blood comes in contact with the meninges irritation occurs. Meningismus is related to meningitis which is the inflammation and infection of the meninges. Both meningismus and meningitis creates a sort of a pouch due to the accumulation of pressure on the meninges.
A person cannot discount this kind of pain. For one, it is usually considered as the “worst headache” ever experienced by a person. For another, there might be some hemorrhaging involved, causing this pain. Lastly, this may be a precursor to an aneurysm, which is usually fatal unless treated immediately. Technically, an aneurysm is a bubble waiting to explode. When it does, the damage is called a subarachnoid hemorrhage.
Compared to meningitis, meningismus occurs less often. In terms of symptoms, meningismus does not lead to fever. Other symptoms of this condition include neck stiffness, light sensitivity, headaches, nausea, and in extreme cases, the loss of consciousness. In addition, doctors find other signs which indicate this condition, including abnormalities in the cranial nerves especially those affecting eye movement and stroke symptoms when meningismus occurs in large arteries.
Doctors test for meningismus in several ways. Neck stiffness can be directly felt when flexing the neck or moving the neck through its normal range. Other tests a doctor can do include testing for Brudzinski and Kernig signs. In these tests, the patient lies flat and an extremity (usually the leg) is stretched beyond normal range. The leg would not move beyond a given set of parameters due to the tension the meningismus puts on the spinal cord.
In addition to the above, stroke symptoms can also occur. These include weakness along one side or both sides of the body, the loss of speech abilities, neglect, or even loss of motivation.
As stated above, meningismus may be a precursor to an aneurysm. If detected within the first 12 hours after the start of the meningismus, a non-contrast CT scan can confirm its diagnoses. The sensitivity of the test is rated at 100% during this period. The sensitivity declines after 12 hours. The sensitivity declines to 93% after 24 hours; and after seven days, it further declines to 50% sensitivity.
If the CT scan does not show any signs of the subarachnoid hemorrhage between the 12- to 24-hour mark a lumbar puncture can be done to test it. The lumbar puncture does not help with the diagnosis within first 12 hours because it might miss identifying subarachnoid blood.
The lumbar puncture would test for the number of red blood cells (RBC) in the cerebrospinal fluid (CSF). The CSF is taken serially. If the RBC is high and does not go down in the serially taken samples, then subarachnoid hemorrhage can be a suspect. Additionally, a CSF analysis can show a yellowing of the CSF, also called xanthochromia. This can be quantified with the use of a spectrophotometer. Further testing in the diagnosis is needed to determine what cause of treatment needs to be followed.
If there is a sign of infection, the doctor can treat it with very aggressive antibiotics or another round of treatment. In cases where there are tumors or masses growing, a biopsy is needed to determine if the mass is cancerous. The reason for this is that not all tumors in the head or brain are operable. Some like too close to vital functions of the brain and can cause irreparable damage when removed.
However, not all headaches are signs of tumors and masses. Some can be treated rather fast and can be addressed in as short as a few weeks. Of course, there is a need for constant monitoring and observation if the headaches become less frequent and less painful.
The takeaway is, always see a doctor whenever you experience something unusual in your body. If you’re suffering from a headache, don’t always reach for a bottle of Advil and shrug it off as just being tired or suffering from lack of sleep. It’s better to err on the side of caution than to regret things in the end.