A handbook of the theory and practice of medicine / by Frederick T. Roberts.
- Frederick Thomas Roberts
- Date:
- 1873
Licence: Public Domain Mark
Credit: A handbook of the theory and practice of medicine / by Frederick T. Roberts. Source: Wellcome Collection.
960/1060 page 956
![Tubercular Meningitis—Acute Hydrocephalus. Etiology.—The immediate cause of this variety of meningitis is the local irritation set up by tubercles. Therefore, all causes predisposing to tuberculosis may be considered as predisposing to tubercular meningitis, and where a hereditary tendency exists, whatever leads to undue local excitement in connection with the brain, as forciug the mental faculties in young children, tends to give rise to a deposit here. Children are by far the most frequent subjects of tubercular meningitis, especially from two to ten years of age, but it may be met with from earliest infancy to old age, and is not uncommon up to the time of puberty and in voung adults. Hereditary predisposition exists in a large majority of cases. This complaint not unfrequently follows one of the exan- themata. Anatomical Characters.—Miliary tubercles are found in greater or less abundance in the meshes of the pia mater, often adhering to the under surface of the arachnoid. They are fre- quently whitish and opaque, or may be softened and yellowish in ] the centre. They may appear scattered all over the surface, but are principally seen about the base of the cerebrum, in the fis- j sures, especially the fissure of Sylvius, and along the chief ' branches of vessels. The membranes are injected, especially the pia mater. The surface of the arachnoid feels sticky, and a thin layer of soft lymph or puriform matter can often be scraped off. This usually exists in abundance between the arachnoid and pia mater, especially about the base and in the fissures; the pia mater is thickened and its meshes infiltrated with the same ma- terial or with serum. As a rule there is little or no fluid in the arachnoid sac. Occasionally the signs of inflammation are chiefly over the convexity. The ventricles of the brain, however, gener- ally contain a considerable quantity of colorless, usually some- what turbid and flocculent serum, often amounting to some ounces in each lateral ventricle, and this leads to oedema, mace- ration, and softening of the surrounding brain-structures, dilata- tion of the spaces and their communicating channels, and frequently to compression of the convolutions of the cerebrum against the skull, so that they are flattened and pale. Some-](https://iiif.wellcomecollection.org/image/b20402740_0960.jp2/full/800%2C/0/default.jpg)
