Meningitis in Closed Head Injury 2 Years Experience at Lahore General Hospital

During the time period of January 2006 till December 2007 there were 114300 patients with closed head injuries admitted at The Department of Neurosurgery Lahore General Hospital Lahore. The patients with closed head injury who developed meningitis were 17 and presented with headache, vomiting and neck stiffness. Headache was the commonest symptom. Diagnosis was made with the help of post contrast CT scan brain and CSF examination. Majority of patients admitted with head injury were adults while among patients who developed meningitis predominantly were children. Road traffic accident was the commonest cause of trauma. Majority developed meningitis within 6 weeks of trauma. There was no patient who developed meningitis after 12 weeks. Glasgow coma score at admission was above 8 in most of the patients. All patients were treated with combination of antibiotics for 6 to 12 weeks. Clinically outcome was moderate disability and good recovery in most of the cases. Conclusion:  Meningitis may occur following closed head injury. Its incidence is more in children than in adults. Responsible organism is not commonly identified on CSF examination. Outcome is reasonably good after proper management. Prophylactic antibiotics to all patients with closed head injury are not required