The penetration of meningococcus from the blood to the cerebrospinal fluid (CSF) initiates an endotoxin and inflammatory-mediated CSF response. This process results in leakage of protein and fluid from the cerebral vasculature, causing cerebral oedema and cerebral vascular thrombosis. The increase in brain water content produces raised intracranial pressure, with a subsequent reduction in cerebral perfusion, and the potential for brain death.