Case 1
A 7-year-old boy has a 2-day historyof severe headache, nausea, fever, and photophobia. He appearslethargic and ill. His temperature is 40oC, and he hassome nuchal rigidity. The most likely diagnosis in this case isbacterial meningitis.
In order to find the causative agent,a lumbar puncture is requested by the physician. Laboratoryanalysis confirms bacterial growth in the cerebrospinal fluid(CSF). Appropriate antibiotic therapy is administered and thepatient recovers without any complications.
1. Where along the vertebral column isthe needle typically inserted in order to perform a lumbarpuncture? Provide an anatomical explanation for youranswer.Ă‚Â Ă‚Â
2. Explain why the needle is inserted in the median plane.
3. Following the procedure, the patient complains of a severeheadache. Explain the possible causes for this complication.
4. Identify the most common causativeorganisms of meningitis.
5. Explain the various anatomicalpathways of the bacteria from the external environment to the CSFinside the brain ventricles.Ă‚Â Ă‚Â
6. Outline two reasons for the boy’snausea, and photophobia.
7. Explain the structures, site ofproduction and pattern of circulation of CSF throughout thebrain.
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