Brudzinski’s Sign in Meningitis (first described in 19th century by Dr. Josef Brudzinski)
Brudzinski's sign is characterized by reflexive flexion of the knees and hips following passive neck flexion by the examiner. Passive neck flexion causes spinal cord movement and stretching of the meninges, resulting in pain for patients with meningitis.
While the pathophysiology for the hip/knee flexion is not completely understood, the theory is that hip and knee flexion occurs as an involuntary reflex to create maximal relaxation of the meninges, reducing pain.
While Brudzinski's sign is commonly used to assess for meningitis, it has low sensitivity. An additional limitation of Brudzinski's sign is the fact the sign is not useful in certain populations. In very young (less than 2 months), immunocompromised and elderly patients, Brudzinski's sign may be absent despite severe disease.
Video by Dr. Victor Sanna - https://www.instagram.com/neurosurg
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