Post craniotomy, which sign would suggest meningitis?

• A. Positive Brudzinski's sign
• B. Negative Kernig's sign
• C. Absence of nuchal rigidity
• D. Glasgow Coma Scale score of 15

Answer: (A)

When the meninges are irritated, secondary signs of meningeal inflammation appear. Brudzinski’s sign is tested by passively flexing the neck; if this causes the hips and knees to flex involuntarily, it reflects meningeal irritation—classic for meningitis. In a post-craniotomy patient, a positive Brudzinski sign directly points to a meningitis process rather than other postoperative issues.

The other options don’t support meningitis as clearly: a negative Kernig sign doesn’t indicate meningitis, absence of nuchal rigidity argues against it, and a Glasgow Coma Scale of 15 means full alertness and doesn’t by itself indicate meningitis.