Hyperextension of the head with pain on flexion indicates what clinical issue?

• A. Meningeal irritation
• B. Tension headache
• C. Visual disturbance
• D. Ear infection

Answer: (A)

Movement of the neck causing pain points to irritation of the membranes around the brain and spinal cord. When the meninges are inflamed, as in meningitis, neck movements—especially extending or flexing the head—trigger pain and stiffness. This meningeal irritation can produce signs such as Brudzinski’s sign, where neck flexion leads to involuntary movement elsewhere, reflecting the meninges’ sensitivity. Tension-type headaches don’t show these classic neck signs, visual disturbances aren’t tied to meningeal irritation, and ear infections don’t produce positive meningeal signs. So hyperextension of the head with pain on flexion best indicates meningeal irritation.