Viral meningoencephalitis and head injury

Abstract

Among 162 children referred with head injury (in a 3-year period) a viral meningoencephalitis was proven to be present in seven cases. Only one patient showed symptoms of infection before the accident. On admission classical signs of viral meningoencephalitis were absent or mixed with the complications of head injury. A diagnosis of viral meningitis/meningoencephalitis was documented by immunofluorescent demonstration of viral antigens in CSF cells and/or pattern of CSF cytology and/or conventional serological methods. Whether the trauma and the infection are coincidental or causally related can not be decided definitively. A hypothesis is presented suggesting diminished alertness in subclinical viral meningoencephalitis, leading to accident proneness.

Nervous system complications of herpes zoster: immunofluorescent demonstration of varicella-zoster antigen in CSF cells

“…After conjugation with FITC the sera were adsorbed with liver powder and lyophilised in 1.0 ml aliquots (Peters et al, 1978b). Immunofluorescence (IMF) tests were performed on the CSF slides by the indirect method: positive and negative control slides were included in the tests (Peters et al, 1978a, b). All slides were numbered and the results were read blind.…”

“…our cases 9 and 10) a minimal score of three positive cells with a typical fluorescence (intranuclear or intranuclear and cytoplasmic in VZ cases) was considered as a positive result of the immunofluorescent test. Paired serum samples were examined for complement fixing antibodies against mumps, Sendai, Herpes virus hominis (HVH), cytomegalovirus, varicella-zoster virus, Coxsackie A and B and ECHO viruses (Peters et al, 1978a).…”

“…As CNS involvement in herpes zoster is not infrequent, and morbidity and mortality are not demonstration of the VZ antigen in CSF cells by immunofluorescence is equally convincing evidence for viral CNS infection (Sommerville, 1966;Dayan and Stokes, 1973;Taber et al, 1973Taber et al, , 1976Lindeman et al, 1974;Peters et al, 1978a, b).…”

Unsuspected Meningoencephalitis in a Case of Assault by Blunt Force Trauma

“…In a study of 162 children referred with head injury, Peters and others 16 have shown the presence of unexpected viral meningoencephalitis in 7. The authors suggested that the subclinical infection led to accident proneness.…”