Cerebrospinal meningitis is defined as an inflammation of the meninges of the brain and spinal cord.

The most common causative bacterial agents of the condition are Neisseria meningitidisand Streptococcus pneumoniae. Meningococcal meningitis tends to occur in epidemics among closed populations such as military barracks. The pneumococcus organism causes most of adult meningitis conditions. At risk for the disease are alcoholics; and persons with chronic otitis, sinusitis, and mastoiditis. Other etiologic factors include: closed head injury with cerebrospinal fluid (CSF) leaks; pneumococcal pneumonia; sickle cell disease; and absence of the spleen (asplenia).

Acute meningitis is characterized by prodromal illness or sore throat, which may proceed to a moderate or irregular fever, intense headache, stiff neck, loss of appetite, and vomiting. There may also be intolerance to light, sound, contracted pupils, and delirium. The person may become desperately ill within 24 hours.

Accurate and speedy diagnosis is urgent. Tests may include: a lumbar puncture after a computed tomography (CT) scan has ruled out the presence of a mass or lesion; magnetic resonance imaging (MRI); complete blood count (CBC); and cultures of blood, nasopharyngeal and respiratory secretions, urine, and skin lesions.

Multiple antibiotics may be used. The types of antibiotics used will depend on the causative organism. Corticosteriods may also be used. Supportive therapy for fever, dehydration, and electrolyte disorders is initiated.

Residuals may vary based on prompt diagnosis and treatment of the condition, and the person's response to treatment. Residuals may include signs of cranial nerve damage or cerebral infarction (CVA), recurrent convulsions, or mental retardation.

• May be entitled to special monthly compensation where the veteran has a single service-connected disability rated as 100% with additional service-connected disability or disabilities independently ratable at 60% or more, which are separate and distinct from the 100% service-connected disability and involves different anatomical segments or bodily systems. See  38 CFR 3.350(i)(1) – Special Monthly Compensation (SMC)

• Review 38 CFR 3.317(d) for presumptive service connection based on infectious diseases

• It is required for the minimum ratings for residuals under diagnostic codes 8000-8025, that there be ascertainable residuals. Determinations as to the presence of residuals not capable of objective verification, i.e., headaches, dizziness, fatigability, must be approached on the basis of the diagnosis recorded; subjective residuals will be accepted when consistent with the disease and not more likely attributable to other disease or no disease. It is of exceptional importance that when ratings in excess of the prescribed minimum ratings are assigned, the diagnostic codes utilized as bases of evaluation be cited, in addition to the codes identifying the diagnoses.

• Disability in this field is ordinarily to be rated in proportion to the impairment of motor, sensory or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, injury to the skull, etc. In rating disability from the conditions in the preceding sentence refer to the appropriate schedule. In rating peripheral nerve injuries and their residuals, attention should be given to the site and character of the injury, the relative impairment in motor function, trophic changes, or sensory disturbances.  38 CFR 4.120

• With the exceptions noted, disability from the following diseases and their residuals may be rated from 10 percent to 100 percent in proportion to the impairment of motor, sensory, or mental function. Consider especially psychotic manifestations, complete or partial loss of use of one or more extremities, speech disturbances, impairment of vision, disturbances of gait, tremors, visceral manifestations, etc., referring to the appropriate bodily system of the schedule. With partial loss of use of one or more extremities from neurological lesions, rate by comparison with the mild, moderate, severe, or complete paralysis of peripheral nerves” 38 CFR 4.124a