THE ETIOLOGY OF PACHYMENINGITIS HEMORRHAGICA INTERNA IN INFANTS

Abstract

Since the first accurate description of pachymeningitis hemorrhagica interna by Virchow¹in 1856, observers have differed in their views regarding the exact nature of this condition. Virchow believed that the membrane formation on the inner surface of the dura precedes the hemorrhage. Huguenin²maintained that the hemorrhage is primary, the organization of the clot causing the membrane formation. The work of Melnikow-Raswedenkow³and others supported Virchow's view, which has gradually become the prevailing one. It was thought that most of the cases seen in the adult⁴resulted from sclerotic changes incident to chronic diseases of the brain, heart, kidneys and lungs. Similarly, regarding cases occurring in the infant, the prevailing opinion seemed to be that pachymeningitis is secondary to other diseases, the cerebral changes being usually discovered at necropsy in infants dying from various infectious diseases, or in chronic cachectic conditions.⁵ Kremiansky⁶performed experiments