MENINGITIS
MENOPAUSE
There may also be speech loss or visual
disturbance. If the tumour invades the
skull bone, there may be thickening and
bulging of the skull.
Meningiomas
can
be detected by
X-ray
or
CT scanning
,
and
MRI
of the
skull, and can often be completely re-
moved by surgery. Otherwise, treatment
is by
radiotherapy
.
meningitis
Inflammation of the
menin-
ges
(membranes covering the
brain
and
spinal cord
), usually due to infection.
Viral meningitis tends to occur in epi-
demics in the winter; it is relatively mild.
Bacterial meningitis is life-threatening.
It is mainly caused by the
Haemophilus
influenzae
bacterium, and
MENINGO-
COCCUS
type B and C bacteria.
The infection
usually reaches
the
meninges via the bloodstream from an
infection elsewhere in the body. Less
commonly, it passes through skull cavi-
ties from an infected ear or
sinus
, or
from the air following a
skull fracture
.
The main symptoms are fever, severe
headache, nausea and vomiting, dislike
of light, and a stiff neck. In viral menin-
gitis, the symptoms are mild and may
resemble influenza. In bacterial menin-
gitis, the main symptoms may develop
over only a few hours, followed by
drowsiness and, occasionally, loss of
consciousness. In about half the cases
of meningococcal meningitis, there is
also a rash under the skin that does not
fade with pressure (see
glass test
). The
rash starts as pin-prick spots that can
join to give a bruise-like appearance.
To make a diagnosis, a
lumbar puncture
is performed. Viral meningitis needs no
treatment and usually clears up within a
week or two with no after-effects. Bacte-
rial meningitis is a medical emergency.
It is treated with intravenous
antibiotic
drugs
.
With prompt treatment, a full re-
covery is usually made. However, brain
damage may occur in some cases.
Vaccines are now given to protect chil-
dren against
2
of the major types of
bacterial meningitis: those caused by
the
HAEMOPHILUS INFLUENZAE
bacterium
and the
m eningococcus
type C bacte-
rium (see
immunization
). For other types
of bacterial meningitis, antibiotic drugs
are given as a protective measure to
people who have come into contact
with the infection.
meningocele
A protrusion of the spinal
cord
meninges
under the skin that is
caused by a congenital defect in the
spine (see
spina bifida
).
meningomyelocele
Another name for
myelocele
(see
spina bifida).
meniscectomy
A surgical procedure in
which all or part of a damaged
meniscus
(cartilage disc) is removed from a joint,
almost always from the knee. Menis-
cectomy may be carried out when
damage to the meniscus causes the
knee to lock or to give way repeatedly.
The procedure cures these symptoms
and reduces the likelihood of premature
osteoarthritis
in the joint.
Arthroscopy
may be carried out to
confirm and locate the damage, and the
damaged area removed by instruments
passed through the arthroscope.
Alternatively, the meniscus may be
removed through an incision at the side
of the
patella
(kneecap).
In either case, there may be an in-
creased risk of osteoarthritis in later
life, but this is less than if the damaged
meniscus had been left in place.
meniscus
A crescent-shaped disc of
cartilaginous tissue found in several
joints. The
knee
joint has 2 menisci, and
the
wrist
joints,
and the
temporo-
mandibular joints
of the jaw, have one
each. The menisci are held in position
by
ligaments
and help to reduce friction
during joint movement.
menopause
The cessation of
menstrua-
tion
, which usually occurs between the
ages of 45 and 55. The term is usually
used to refer to a period of physical and
psychological changes that occur as a
result of reduced
oestrogen
production.
Symptoms of menopause include
hot
flushes
and night sweats; vaginal dry-
ness caused by thinning of the vaginal
skin; and a decrease in vaginal secre-
tions. The vagina shrinks and loses
elasticity, and becomes prone to minor
infections. Vaginal dryness may also
make sexual intercourse more difficult
and painful (see
vaginitis
). The neck of
the bladder and urethra undergo similar
changes, which can result in a feeling of
needing to urinate frequently.
363
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