Most of these are secondary to some other lesion and they are usually of minor consequence. We have seen that aneurysms, although situated in the meninges, give rise, when they rupture, to cerebral haemorrhage more than to meningeal.

There are again numerous small haemorrhages occasionally in anthrax, haemophilia, scurvy, and ulcerative endocarditis. There are also haemorrhages from injuries to the skull, especially when they involve lacerations of the brain. But there is one form which is primary and of considerable importance.

Infantile Meningeal Haemorrhage

In severe and prolonged labours, where the head is much compressed and there is obstruction of the vessels, haemorrhage sometimes takes place on the surface of the brain. It is important because it may lead to permanent injury to the brain. The haemorrhage is usually bilateral over the convexity or at the base, and in the former case it occupies chiefly the central region towards the middle line. The brain beneath is sometimes much injured, being lacerated and infiltrated with blood. When at the base, the haemorrhage is chiefly in the posterior fossa, the blood lying on the pons, medulla, and cerebellum, and generally arising from a laceration of the cerebellum.

As the blood is absorbed there may remain a permanent atrophy of the parts which had been injured. There may be thus a depression over the central convolutions which are dwarfed and indurated, and the usual secondary degenerations may ensue.

During life, there may be little that is noteworthy in the child immediately after birth, but as the powers develop it may show motor weakness and rigidity of limbs, along with more or less mental defect. The resulting paralysis may be either hemiplegic or paraplegic in distribution according as the lesion is unilateral or bilateral. There is often considerable improvement as life goes on.

Literature

Hematoma - Prescott Hewett, Med. chir. trans., 1845; Virchow, Wiirzb. Verhandl., 1856, vii.; Huguenin, Ziemssen's Handb., xi.; Rindfleisch, Path, histol. (Syd. Soc. transl.), 1873, ii., 302; Coats, Joum. of Path., i., 1893. Infantile lut-morrhage - Little, Obstet. trans., 1862; M'Nutt, Amer. Jour, of Med. Science, 1885; Gowers, Dis. of nerv. syst., ii., 1893, p. 413.