Internal Hemorrhagic Pachymeningitis in Young Children

Abstract

Despite the fact that internal hemorrhagic pachymeningitis is not uncommon during infancy, there are few cases reported in the literature. Moreover, comparatively few have been followed over prolonged periods of time, so that observations as to sequelae are incomplete. Recovery following the initial lesion is usual, although Burhans and Gerstenberger 1 found that many of these infants later showed a permanent disability. Feer2 and Finkelstein3 expressed the belief that hydrocephalus was the most frequent sequel. Rosenberg 4 was able to locate a few of his patients eight or nine years after the first appearance of the disease and found that 70 per cent had some defect directly traceable to the original lesion.Virchow,5 who first described the condition, believed that the primary lesion was a proliferation of subendothelial tissue followed by serofibrinous exudate and hemorrhage. This view was also supported by Heschl6 among the earlier writers. On the other hand, Wiglesworth 7 considered hemorrhage to be the primary lesion. Doehle,8 as well as Burhans and Gerstenberger, believed that the formation of