PÆDIATRICS

Subdural Effusions and Pyogenic Meningitis. P. BENSON et alii (J. Pediat., November, 1960) have investigated patients in whom subdural effusions complicated acute purulent meningitis for the presence of clinical and developmental abnormalities at follow-up, and used as a control group patients in whom subdural taps were "negative". More than 50% of the patients were examined more than four years after their acute meningitis. In the majority of instances meningitis was caused by Hcemophilus influenzw, but this organism was not found more frequently in patients with effusions than in the controls. Patients with pneumococcal meningitis seemed more likely and those with meningococcal meningitis less likely to develop subdural effusions than not. A relatively poor prognosis was associated with the presence of coma, convulsions, or neurological abnormalities at the onset of the acute meningitis. This was true in the presence or in the absence of effusions. Among those with effusions permanent sequelse tended to be more frequent in those in whom effusions were large and persisted for long periods of time. In patients treated with subdural taps alone prognosis was better when the indication for termination of therapy was evidence of a dry subdural space than when drainage was discontinued earlier. Patients in whom membranes were seen and excised did very well in spite of the presence of previously stormy courses, while those in whom membranes were seen and not removed had a high incidence of permanent sequelee.