CENTRAL NERVOUS SYSTEM
- The scalp and skull were normal.
- The brain weighed 1400g and appeared swollen.
- The membranes displayed purulent exudate, particularly prominent along the inner surface - look carefully at the picture (on the left) and you can see a creamy-white covering in places.
- The Circle of Willis showed mild atheromatous changes.
- As mentioned, a lumbar puncture taken while the patient was alive showed large numbers of Haemophillus sp. in the cerebro-spinal fluid.
- A speciman was taken for microscopy, the slides are shown in the image (below, right). The meninges on the left of this slide are normal, those on the right shows the typical appearance of meningitis. As you can see, there is a large amount of exudate on this side, made up mostly of neutrophils. In addition, the nervous tissue shows signs of oedema - this is due in part to the fact that the disease also affects blood flow, constricting the vessels around the meninges.