This "lucid interval" helps to distinguish the symptoms due to middle meningeal hæmorrhage from those of laceration of the brain substance, as in the latter the symptoms of concussion merge directly into those of compression.
Relations of the Middle Meningeal Artery and Lateral Sinus to the surface as indicated by Chiene's Lines.
The condition differs from compression due to middle meningeal hæmorrhage in that it is less severe and is not steadily progressive.
Between the fibrous layer and the bone the meningeal vessels ramify; and along certain lines the two layers split to form channels in which run the cranial venous sinuses.
So long as the fracture is simple, it can scarcely be diagnosed except by inference from the associated symptoms of meningeal or cerebral injury.
The commonest cause of extra-dural hæmorrhage is laceration of the middle meningeal artery.
When the disease is of the meningeal type, symptoms of general purulent lepto-meningitis assert themselves, and soon come to dominate the clinical picture.
We have known of a case of a man who died of meningitis resulting from a punctured fracture of the vault caused by the spoke of an umbrella, the fracture having escaped recognition until the meningeal symptoms developed.
These may be due to arrest of development of the brain, to injuries of the head at birth, to meningeal hæmorrhage, or to other lesions of the brain, with secondary degenerative changes in the spinal cord.
A is over the anterior branch of the middle meningeal artery, and the bifurcation of the lateral or Sylvian fissure; AC follows the horizontal limb of the lateral fissure.
The recoil of the skull after the blow separates the dura from the bone, and if the meningeal artery is lacerated or punctured, blood is effused into the space thus formed (Fig.
Pepper records a case in which a knife was thrust through the spheroidal fissure, wounding a large meningeal vein, causing death from intracranial hemorrhage.
Meningeal symptoms were characteristic of the third visitation of the disease.
It is quite remarkable that the lead should have remained such a length of time without causing meningeal inflammation.
The saw cut directly down into the brain, severing the superior longitudinal sinus, besides tearing a branch of the meningeal artery.
Gamgee tells of a constable who was stabbed in the left ear, severing the middle meningeal artery, death ensuing.
It is the only case of infected meningeal hemorrhage observed by Guillain and Barré in a wide experience.
The meningeal hemorrhages are hardly enough to explain the death.
Possibly Case 109 should be set down as an unusual example of shell-shock psychosis, chiefly dependent upon meningeal hemorrhage.
As a rule such hemorrhages remain aseptic, and in fact meningeal hemorrhage is said by Guillain and Barré to have, as a rule, a favorable prognosis.
According to Chavigny, so slight a meningeal hemorrhage is incapable of producing a mechanical disturbance of the brain and the cause of death could not be said to be meningeal hemorrhage.
The above described case was the only one of infected meningeal hemorrhage that had occurred in the Sixth Army Neurological Center.
In one, however, he includes both the general physical disturbances, incomplete paralysis, and final coma characteristic of tumor and the epileptiform attacks so often due to peripheral or meningeal irritation.
The prognosis is more unfavorable than in similar cases in acquired syphilis, the meningeal and vascular lesions being the most frequent and showing themselves very obstinate even under careful treatment.
Early in the course of spinal meningitis there exists a spasmodic condition of the sphincters: these muscles are also paralyzed in spinal and in meningeal hemorrhage, and from the pressure of tumors upon the cord giving rise to paraplegia.
The injury has, however, also caused a rupture of an important artery which occurs in one of the membranes of the brain in this region, the middle meningeal artery.
As a rule, it is greater the longer the attack has lasted, and is by no means equally diffused, but is more marked where the meningeal alterations are greatest.
In a case in Dublin,[47] there was no meningeal lesion except in a "few dark spots like sanguineous effusion under the arachnoid.
That drug indeed relieves the spinal spasms of tetanus--a disease in which there is an irritation of the spinal axis, but no exudation from its meningeal vessels, as in the affection we are studying.
The tubercles resulting from inoculation often resemble in structure the meningeal tubercles of the brain rather than the type presented by tubercles in lymphatic glands.
Ecchymoses of the membranes are occasionally observed, and in one of our cases extensive meningeal hemorrhage was found.
On post-mortem examination there was not the slightest appearance of any meningeal lesion, except a few dark spots like sanguineous effusion under the arachnoid.
These descriptions correspond in all respects with those of Mathey relating to the epidemic at Geneva in 1805, for he says: "The meningeal blood-vessels were strongly injected.
Sometimes headache or other cerebral symptoms arise, probably from the fact that the meningeal artery, which supplies the meninges, is connected by anastomosing branches with the tympanum.
Occasionally, the parotitis disappears a variable time before the onset of the metastatic affection; then the interval is marked by grave symptoms of depression and cerebral disturbance, but there are no proofs of actual meningeal involvement.
The very reasons that militate against its being regarded as a meningitis forbid its being considered as a meningeal fever.
In an adult, immediate exploration of the mastoid and antrum is indicated on the onset of meningeal symptoms, even although they occur during the course of an acute middle-ear suppuration.
If signs of meningeal irritation occur, the wound should be inspected, and if there be any evidence of localized meningitis, it should at once be surgically treated.
Marked increase of polynuclear cells is said to point to acute and intense inflammation, whereas an abatement of the polynucleosis may be taken as a sign of diminution of the meningeal irritation.
If symptoms of a cerebellar abscess or of meningeal irritation be present in addition to those suggestive of a labyrinthine affection.
Yawning occurs in a most intractable form in meningeal affections, and in cerebral and cerebellar tumours.
The extravasation had here taken place gradually, as is characteristic of hemorrhage from the middle meningeal artery, and perhaps the excitement due to the drinking had influenced it.
We have referred to one case of extradural hemorrhage from spontaneous rupture of the middle meningeal artery.
The latter cases are almost always due to the effects of violence, though there is at least one case of apparently spontaneous rupture of the middle meningeal artery.
The latter symptoms are most marked in meningeal hemorrhage in which paralysis is delayed in appearance and generally incomplete.
They even seem to have known of accidents such as we now discuss in connection with the laceration of the middle meningeal artery.
A very unusual form is meningeal bleeding, giving rise to symptoms of apoplexy.
Finkelstein also has drawn attention to the occurrence of meningeal hemorrhage, and Hess and Fish reported obtaining bloody cerebrospinal fluid from a case withmeningeal symptoms.
Meningeal hæmorrhage of either form is one of the slighter lesions, and less dangerous, both as an immediate condition and as to the probabilities of after trouble.
In the majority of the cases pain must have depended on meningeal hæmorrhage.
I never saw a typical case of middle meningeal hæmorrhage, although many fractures crossing the line of distribution of the large branches came under observation.
The above list will hopefully give you a few useful examples demonstrating the appropriate usage of "meningeal" in a variety of sentences. We hope that you will now be able to make sentences using this word.
