Causes of symptoms and kerniga Brudzinskogo

Kernig's sign is one of the important markers of lesion of cerebral membranes in stroke (bleeding in brain), meningitis, irritation of membranes with bacterial infections.

The pathology is Called by the name of a therapist from Russia kerniga Vladimir Mikhailovich, who studied reflexes from inflammation of the membranes of the brain.

the test for Kernig's sign


Identify the Kernig's sign (reflex syndrome) according to the following criteria:

  • Flexing the legs at an angle of 90 degrees in knee and hip joints – the first phase;
  • extension of the knee phase two.

Reflex is considered positive in case of impossibility of full extension in the knee joint when the reflex spasm of the skeletal muscles of the tibia.

Kernig's sign positive from both parties in meningitis, irritation of the meninges with increased intracranial pressure. And there he was in trauma of the skull with hematoma (limited accumulation of blood).

the Syndrome is negative If the patient has a hemiparesis (unilateral increase or decrease in muscle tone) neurological diseases (Alzheimer, Parkinson).

Physiologically positive syndrome may occur in elderly patients with degenerative-dystrophic lesions of skeletal muscles.

To Differentiate the physiological state and pathology of the syndrome will help Brudzinskogo, which reveals signs of lesion of cerebral membranes at the expense of provocation meningeal pose.

There are 5 variants:

  • the Upper positive Brudzinskogo syndrome, when a person cannot cause his chest your head;
  • Zygomatic syndrome Brudzinskogo is assessed by tapping on the zygomatic arch. This will be a bending knee;
  • Cheek – is flexion of forearms and the shoulders lifting when pressure on the cheek;
  • Positive pubic reflex is characterized by flexion of the condition of the knees with pressure on the pubic area
  • Bottom syndrome Brudzinskogo – when you try to bend your leg at the knee joint, the second leg is driven to the stomach involuntarily. The pathology observed in meningeal changes.

Symptoms kerniga Brudzinskogo and when used together provide the neurologist with information regarding the levels of brain lesions.

If the patient has Alzheimer's disease, the appearance of the above reflexes will indicate the degree of degradation of brain tissue.

test symptom Brudzinskogo

liver Disease and meningeal reflexes

liver Disease, accompanied by increased amount of bilirubin in the blood and jaundice, leads to meningeal changes due to the toxic action of substances on the brain tissue. When they experience the following symptoms:

  • Stiff neck
  • Flag position
  • Tonic strain of the back muscles of the thighs;
  • Headaches by increasing intracranial pressure;
  • Curved body;
  • Inverted belly.

Icteric disease of the liver with bilirubin over 70 μmol/l accompanied by pericardial RUB ("pericarditis epistemologically"), which revealed Botkin. Scientist actively investigated the hepatitis b and identified the specific effect of the virus on the brain. Subsequent pathology was named in his honor – Botkin's disease.

Syndrome kerniga in bacterial diseases

several bacterial diseases (salmonellosis, diphtheria, shigellosis) lead to inflammatory changes of the meninges. Kernig's sign in the background of infectious diseases is accompanied by other meningeal signs:

  • the Position "setter" — the back is arched, abdomen retracted, his hands pressed to my chest;
  • Stiff neck.

Reflex and kerniga Brudzinskogo in bacterial infections should be distinguished from antalgic resistance of skeletal muscle.

In children are similar to symptoms observed in Parkinson's disease and myotonia. To identify or rule out the cause of meningeal pathology to help symptoms Brudzinskogo.

Why there are cerebral symptoms and pathological reflexes

Cerebral symptoms appear when any damage of the meninges: inflammatory, traumatic and cancer.

First signs of brain disorders:

  1. increase in the size of the brain;
  2. Increased intracranial pressure
  3. Irritation of the meninges and blood vessels;
  4. Violation of liquor.

When these changes are observed following clinical symptoms:

  • Headache;
  • impaired consciousness
  • convulsions
  • Dizziness;
  • nausea and Vomiting.

The Syndrome of brain disorders manifested by violation of orientation of man in time and space. On the background of metabolic, toxic and vascular changes in brain and trunk tissues violations occur, leading to delirium and to the following criteria:

  1. Delusions and hallucinations;
  2. High sympathetic activitynervous system;
  3. stupor.

Alcohol withdrawal syndrome can also form delirium.

utmost degree of pathology is coma stupor and decerebration rigidity, which is pronounced reflexes and kerniga Brudzinskogo.

However, when stupor and coma off the activity of the cortex of the brain, so active pathologic reflexes cannot be evaluated.

Decerebration rigidity occurs in lesions of the brainstem between the vestibular and red nuclei.

Decortications analog – hearth in the interior of the cerebral hemispheres over the average brain – there is a violation of adduction, and flexion of the hands.

In the initial stages of the pathology appears meningeal syndrome, which manifests itself:

  • Vomiting and dizziness in the morning;
  • Congestive changes in the fundus;
  • Reduced bone density of the skull.

On the background of cerebral edema or increased intracranial pressure always observed seizures in various parts of the body.

It Should be understood that a neurological syndrome kerniga is the first token of subsequent brain changes in lesions of the shells. Its identification is important in the treatment of disease.