Manual of pathological anatomy . nd .the space usually occupied by the cerebro-spinal fluid (subarach-noid space of Hilton), and by dilating the hemispheres, and press-ing them upwards against the cranium causes a flattening of theconvolutions and obliteration of the sulci, which is very obviouswhen the skull is opened. When these phenomena occur as theresult of rapid disease they constitute the condition known asacute hydrocephalus. Affections of the meninges often extend, as has been said, intothe cerebral ventricles, the morbid conditions of which parts willbe considered further on. * Payne
Manual of pathological anatomy . nd .the space usually occupied by the cerebro-spinal fluid (subarach-noid space of Hilton), and by dilating the hemispheres, and press-ing them upwards against the cranium causes a flattening of theconvolutions and obliteration of the sulci, which is very obviouswhen the skull is opened. When these phenomena occur as theresult of rapid disease they constitute the condition known asacute hydrocephalus. Affections of the meninges often extend, as has been said, intothe cerebral ventricles, the morbid conditions of which parts willbe considered further on. * Payne: Trans. Path. Soc. vol. xxi. p. 7. Murchison : Trans. Path. Soc,vol. xviii. p. 14. Dickinson : Ibid. xx. p. 22. Sanderson : Ibid. xvi. p. 30. I 241 TUBERCULAR MEmNGITIS. The deposit of tubercle on tho pia mater of the brain occurs inthe shape of small miliary granules, resembling the Pacchionianbodies in appearance, but differmg from them both in their siteand their microscopic relations. They are not seen on the free Fig. Miliary tubercles in the Sylvian fissure of the brain of a child, aged nineteenmonths, who died ten days from the first appearance of head symptoms. The whitecircular spots represent the tubercles, which were surrounded by highly-congestedblood-vessels. surface of the arachnoid; and, in fact, seem in no way connectedwith this membrane ; a point which establishes a marked differencebetween it and the serous membranes of the thorax and the abdo-men. They are found most frequently deeply within the Sylvianfissure, in the convolutions of the brain, and at the base; they areof the size of pins heads, and appear in the form of grey granu-lations, imbedded among a vascular network ; they are very rarelyfound upon the cerebellum. A careful examination is necessary,to prevent their being overlooked; but if not seen on the pia materitself they may often be found on the minute vessels proceedingfrom the pia mater into the brain or on the delicate processes ofpia
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