Meningitis is an inflammation of the meninges, the tissue covering of the brain and the spinal cord. Bacteria and viruses are the most common causes of meningitis in children, although fungi can cause it in children with a weakened immune system. Children with meningitis have symptoms of fever, headache, irritability, neck stiffness, and photophobia, or an inability to tolerate bright light. Complications of meningitis in children can occur during the infection and beyond.
SIADH
SIADH stands for syndrome of inappropriate ADH secretion. ADH is a hormone the brain secretes to control fluid and electrolyte balance in the body. Meningitis causes swelling and inflammation of the pituitary, the gland that secretes ADH. According to the Children’s Hospital of Boston, excessive production of ADH makes the body retain inappropriate levels of water, causing the levels of certain electrolytes such as sodium, to drop. Children with SIADH can feel nauseous and vomit, be irritable and suffer changes in mental status such as confusion, hallucinations and even coma. Fluid restriction is the treatment of SIADH until the condition resolves, usually once the meningitis is under control.
Neurological complications
Seizures or convulsions can occur acutely during the course of meningitis and can be one of the initial symptoms. They result from both the irritation on the brain caused by the infection and by the brain swelling that accompanies the body’s response to the infection. These seizures can be hard to control and may require different combinations of anticonvulsants. Children who survive meningitis can have permanent damage in certain parts of their brain, which can lead to a chronic seizure disorder. According to the National Institute of Neurological Disorders and Stroke, other long-term neurological consequences of meningitis include hearing loss, blindness, permanent brain damage, changes in behavior, learning disabilities, memory loss, and muscle weakness and loss of coordination.
Anatomic Complications
The main complication within the brain during meningitis is brain swelling, or cerebral edema. As the swelling progresses, the pressure within the skull also increases, which can result in brain herniation. The brain is enclosed within the skull, but there’s an opening at the base of the skull from which the spinal cord protrudes. If enough pressure builds up within the skull, the brain can begin to protrude through the base of the skull, resulting in herniation, which can lead to permanent brain damage and death. Other complications include hydrocephalus, or buildup of fluid within the brain, stroke and abscesses.
