E50

BRAIN - Meningitis & subarachnoid haemorrhage

Description
There is blood clot in the subarachnoid space, particularly on the undersurface of the left cerebral hemisphere, although it is also apparent on the right. The meninges, particularly over the vertex, show some slight thickening and yellowish discolouration.
History
This man was admitted, at the age of 58, with a past history of diabetes, gout and chronic renal failure. On the present admission, he had been unwell for some weeks with a chronic discharging left ear, more recently fever, malaise and, ultimately, coma. No organisms were isolated, but he was successfully treated with Methacillin and Gentamycin. Subsequently, he had a mastoidectomy carried out and, three days following this, he developed a left-sided ataxia. He later became unconscious, and a subdural haematoma was found in the posterior fossa. Post-operatively, he did not improve and died some 28 hours after the procedure. The conclusion was that his meningoventriculitis led to secondary haemorrhage. No aneurysm was found.