D - GUNSHOT INJURIES AND STAB WOUNDS
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Chronic infection of a vertebra resulting in fistula formation may lead to chronic
inflammatory reactions of the meninges. Fig. 89 shows the result of a contrast filling of
the fistula in the case of a former naval officer who was wounded in the Second World
War. There are also two fine branches of the fistula proceeding towards the nth thoracic
vertebra. At operation, following exposure of the fistula and dirty granulation of the
osteomyelitic bone, I found a massive chronic pachymeningitis post-traumatica with
considerable thickening of the dura. The granulations were removed as far as possible
and following antibiotic therapy the fistula closed. There was no change in the incom
plete transverse lesion below the mid-thoracic cord.
