Signs of meningeal irritation | Maneuver | Positive test |
Kernig sign | Place patient supine with hip flexed at 90 degrees. Attempt to extend the leg at the knee. | The test is positive when there is resistance to extension at the knee to >135 degrees or pain in the lower back or posterior thigh. |
Brudzinski sign | Place patient in the supine position and passively flex the head toward the chest. | The test is positive when there is flexion of the knees and hips of the patient. |
Jolt accentuation of headache | Patient rotates his/her head horizontally two to three times per second. | The test is positive if the patient reports exacerbation of his/her headache with this maneuver. |
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