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Microscopically, a neutrophlllc exudate is seen involvinq the menlnges at the left, witn prominent dilated vessełs. Tnere Is edema and focal inflammation (extending down via the Virchow-Robin space) In the cortex to me rlght This acute menlngltis Is typlcal for bacterial infection.

This edema can lead to herniation and death. Resolutlon of infection may be followed by adhesh/e arachnoiditis wfth obliteration of subarachnoid space leadlng to obstructive hydrocephalus.