THE NERVOUS SYSTEM. 



773 



In almost all cases of tuberculous meningitis there is tuberculous 

 inflammation in other parts of the body. 



Miliary tubercles in the choroid of the eye are present in a considerable 

 proportion of cases. 



The cortex of the brain may be hyperaemic, and punctate haemor- 

 rhages may be present in the cortex and in the pia mater. 



Syphilitic Meningitis, In this form of inflammation, which is usually 

 circumscribed, there is a development of gummy tumors of variable size, 

 frequently associated with simple inflammation of the membrane, either 



508. A MILIARY TUBERCLE OF THE EPENDYMA OF THE LATERAL VENTRICLE. 

 >ws an early stage of tubercle formation on the ependyma without marked caseation. 



with the formation of serum, fibrin, and pus, or with the development 

 of new connective tissue and consequent thickening of the membrane. 

 The gunimata may form in the pia mater covering the convexity, or at 

 the base of the brain. They may grow outward, involving the dura 

 mater; or inward, encroaching upon or involving the brain tissue. 

 Although usually circumscribed, syphilitic inflammation may occur as 

 a diffuse thickening of the membrane. The syphilitic nodules, includ- 

 ing the gummata and new-formed connective tissue, are often very 

 small, but may be as large as a hen's egg. 



TUMORS. 



Hsematoma. In chronic pachymeuingitis of long standing the new 

 connective tissue may form large, flat cysts between the dura mater and 

 the pia mater, which may compress the surface of the brain. The blood 

 originally contained in these cysts may be absorbed and replaced by 



