By the next morning, his nuchal rigidity
had resolved and the amount of pain with passive and active neck motion had decreased markedly.
As intracranial pressure (ICP) increases, patients develop vomiting, lethargy, headaches, and personality changes, as well as cranial nerve palsies and nuchal rigidity
2 2 Moderate to Severe Headache, Nuchal Rigidity
, and/or Visual Disturbances 34.
Hunt and Hess Grading Scheme * Grade Clinical Condition 0 Unruptured I Asymptomatic or minimal headache, nuchal rigidity
II Moderate to severe headache, nuchal rigidity
, no neurological deficit other than cranial nerve palsy III Drowsiness, confusion, mild focal deficit IV Stupor, moderate to severe hemiparesis, possible early decerebrate rigidity and vegetative disturbances V Deep coma, decerebrate rigidity, moribund appearance * Hunt & Hess, 1968; Ogilvy & Carter, 1998.
Kernig's sign, Brudzinski's sign, and nuchal rigidity
have been written about and widely utilized in the clinical diagnosis of bacterial meningitis for more than 100 years, Dr.
Pertinent negative findings included the absence of nuchal rigidity
on physical examination.
Cardiopulmonary and neurologic examination showed tachycardia and nuchal rigidity
Other signs and symptoms that may appear are meningeal irritation characterized by Kerning's sign, Brudzinski's sign and nuchal rigidity
, photosensitivity, abnormal extra ocular movements, facial droop, diplopia, aphasia/dysphasia, contralateral pronator drift and hemiparesis.
He had nuchal rigidity
, dysmorphic facies, and oligodactyly.