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25 Possible Causes for Altered Mental Status, Neck Stiffness, Prominent Sulci

  • Meningoencephalitis

    Neurological examination was normal except for neck stiffness. There was no history of chest pain, cough or breathlessness.[ncbi.nlm.nih.gov] MRI of the brain showed some effacement of cortical sulci, rendering the vessels prominent, with increased T2-weighted signal diffusely scattered throughout both hemispheres[academic.oup.com] An extensive laboratory workup for the etiology of his altered mental status was unremarkable, except for a mildly elevated white blood cell count in the cerebrospinal fluid[mdedge.com]

  • AIDS-associated Meningoencephalitis

    Stiff neck (generally not present in children under the age of one year or in patients with altered mental state), back rigidity, bulging fontanelle (in infants), photophobia[patient.info] MRI of the brain showed some effacement of cortical sulci, rendering the vessels prominent, with increased T2-weighted signal diffusely scattered throughout both hemispheres[cid.oxfordjournals.org] Altered mental status is rare and if present should increase suspicion for acute purulent meningitis or encephalitis.[infectiousdiseaseadvisor.com]

  • Primary Amebic Meningoencephalitis

    stiffness and pain disturbances of taste and smell seizures (fits).[sahealth.sa.gov.au] CT head showed prominent sulci suggestive of cerebral atrophy.[ncbi.nlm.nih.gov] We describe two children, aged four and 14 years, who both presented with seizures and altered mental status after recent fresh water swimming exposures.[ncbi.nlm.nih.gov]

  • West Nile Encephalitis

    In a severe infection, symptoms are headache, high fever, neck stiffness, stupor, disorientation, coma, tremors, convulsions, muscle weakness, paralysis, and on rare occasions[infoplease.com] Arrows indicate subtle enhancement in the sulci. B and C, FLAIR images show increased signal intensity in the sulci, more prominent on the left than on the right.[ajnr.org] We report the case of a 46-year-old woman who presented with fever, altered mental status, and maculopapular rash, who was diagnosed with locally acquired WNV encephalitis[ncbi.nlm.nih.gov]

  • Candida Meningitis

    It must be considered in any patient presenting with fever, headache, or neck stiffness.[ahcmedia.com] […] in modelling of lateral ventricles, slight deviation of middle line to the right side and reduction of sulci dimensions ( A: T2 flair).[bmcresnotes.biomedcentral.com] Prognosis Cryptococcal meningitis The most important markers of poor prognosis in HIV-associated cryptococcal meningitis are altered mental status at presentation and high[online.epocrates.com]

  • Leptomeningeal Metastasis

    A patient with uvular cancer presented with lower limb weakness and paresthesiae, headache, neck stiffness and multiple cranial palsies.[ncbi.nlm.nih.gov] The lesions were more prominent in the cerebellar sulci compared with in the cerebral sulci.[ajnr.org] Patients may present with an altered mental status. Additionally, focal or generalized seizures, as well as meningism, may be reported.[symptoma.com]

  • Brain Stem Herniation

    stiffness Upward brainstem herniation This is alo sometimes known as "ascending teranstentorial herniation".[derangedphysiology.com] The fluid space between the cortex and the calvarium appears to be increased and the sulci/gyri may appear prominent. View prominent sulci/gyri.[hawaii.edu] The most common signs are intractable headache, head tilt, and neck stiffness due to tonsillar impaction.[en.wikipedia.org]

  • Hypoxia

    Seizures, myoclonic jerks (muscle spasms or twitches), and neck stiffness may occur.[neuroskills.com] Grossly, the lesion was marked by preserved gyral crests and involved sulci, resulting in prominent, mushroom-shaped gyri.[emedicine.medscape.com]

  • Hypertensive Encephalopathy

    neck, delirium, seizures, coma) Infectious causes of pediatric encephalopathy (irritability, poor feeding, hypotonia or floppy baby syndrome, seizures, death) The best way[medicinenet.com] There was complete resolution of cerebral edema in all patients and mild interval prominence of the cerebral sulci, which can indicate cerebral volume loss, in three out of[bloodjournal.org] His altered mental status, however, resolved with control of blood pressure.[ncbi.nlm.nih.gov]

  • Postictal State

    Some similarities in the four stages include: Premonitory phase : Hours to days before the pain of a migraine attack, patients experience fatigue, nausea, neck stiffness,[theraspecs.com] Ventricles, sulci and cisterns were mildly prominent for age and there was mild cerebral cortical volume loss.[annals-general-psychiatry.biomedcentral.com] If a patient remains confused for longer than 20 minutes after a seizure, consider another cause of altered mental status [4].[ems1.com]