Virchow,1 in 1857, was one of the first to recognize the difference between traumatic and spontaneous subdural hemorrhage.2 He thought that the latter arose from repeated small hemorrhages of a chronically inflamed dura, and to this condition he gave the name "pachymeningitis haemorrhagica interna." Many since have attempted to evaluate the role of infection in this lesion. Putnam,3a who, in 1925, was the first to review this problem thoroughly, observed that infection had not been proved except as a rare etiologic factor. Leary4 also expressed the belief that the inflammatory cellular reaction is "incidental or accidental."
Baker,5 in 1938, supported Virchow's views, but he offered no additional proof for the infection theory, and it appears that Putnam's conclusions still hold.
Chronic alcoholism was suggested as a cause of subdural hemorrhage by Kremiansky6 in 1868. Leary4 performed autopsy in 50 cases of subdural hemorrhage.