SUBDURAL SUPPURATION ORIGINATING IN PURULENT LEPTOMENINGITIS

Abstract

In the course of routine autopsies we have observed occasional cases of subdural suppuration (figs. 1 and 2) which is apparently secondary to an underlying leptomeningitis. We wish to eliminate from this discussion all cases of subdural infection secondary to causes other than underlying disease of the leptomeninges. Specifically, we exclude subdural suppuration secondary to extension from diseased paranasal sinuses, mastoid air cells and the middle ear. Similarly, we exclude from consideration subdural infection arising from a penetrating cranial injury, infected subdural hematoma and osteomyelitis of the skull. REVIEW OF LITERATURE A diligent search of the literature failed to reveal any papers on this subject except for a single article by Bateman, in 1929.¹ In this report there is a passing reference to subdural suppuration secondary to involvement of the pacchionian granulations in cases of purulent leptomeningitis. PRESENTATION OF CASES In a series of 95 consecutive cases of leptomeningitis