CIRCUMSCRIBED SUPPURATIVE (NONTUBERCULOUS) PERIPACHYMENINGITIS

Abstract

The term "peripachymeningitis" was given by Traube¹ to a combined inflammation of the spinal meninges (dura and pia-arachnoid) and the epidural connective tissue situated between the dura and the periosteum of the vertebrae. Albers² termed this condition perimeningitis; Braun³ called it epimeningitis; others called it pachymeningitis spinalis externa. As the foregoing terms imply an inflammation only of the epidural or epimeningeal tissues, it would be proper to reserve Traube's term peripachymeningitis for cases in which a perimeningitis is associated with a pachymeningitis and leptomeningitis. In either condition the main pathologic changes are in the perimeningeal tissues which, as first pointed out by Vulpian,⁴ may be either infiltrated with pus or transformed into "sclerotic tissue." This is sometimes so abundant that it may resemble a veritable new growth. It is thus a purely local process involving only a circumscribed area in the epidural space. As a rule