Brudzinski

Brudzinski is an eponym in clinical neurology and pediatrics, referring to several signs described by the Polish physician Jan Brudziński that indicate meningeal irritation. The signs are most often associated with meningitis or other conditions causing inflammation of the meninges, and they may also be observed in subarachnoid hemorrhage or intracranial infections. The two best-known manifestations are the Brudzinski sign and the Brudzinski-Kernig sign.

Brudzinski sign (neck sign) is tested with the patient lying on the back. Passive flexion of the neck toward the chest causes involuntary flexion of the hips and knees. A positive sign suggests meningeal irritation.

Brudzinski-Kernig sign refers to the combination of findings related to both Brudzinski and Kernig signs. In this assessment, neck flexion may reproduce the hip and knee flexion (Brudzinski aspect). When the knee is extended with the hip flexed at 90 degrees, resistance or pain upon further extension (Kernig sign) may be elicited. The presence of either or both signs supports consideration of meningitis in the appropriate clinical context.

Clinical use and limitations: These signs are historical components of the neuromeningeal examination. They have variable sensitivity and specificity and are not diagnostic on their own. Modern evaluation relies on a combination of clinical assessment, lumbar puncture with CSF analysis, and imaging as indicated. See also Kernig sign and meningitis for related examination findings.