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Am J Dis Child. 1916;XI(1):23-32. doi:10.1001/archpedi.1916.04110070034004.
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Since the first accurate description of pachymeningitis hemorrhagica interna by Virchow1 in 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. Huguenin2 maintained that the hemorrhage is primary, the organization of the clot causing the membrane formation. The work of Melnikow-Raswedenkow3 and others supported Virchow's view, which has gradually become the prevailing one.

It was thought that most of the cases seen in the adult4 resulted 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

Kremiansky6 performed experiments


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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