A Rich focus is a tuberculous granuloma occurring within the cortex or meninges of the brain that ruptures into the subarachnoid space, causing tuberculous meningitis. [1] The Rich focus is named for Arnold Rice Rich, a pathologist at Johns Hopkins Hospital, who along with his colleague Howard McCordock first described the post-mortem finding of caseous foci within the cerebral cortex or meninges which appeared to predate the development of meningitis. [2] Prior to their research the prevailing view had been that meningitis occurred as a result of the dissemination of tuberculous bacilli associated with miliary tuberculosis and that these processes occurred at the same time.
More recently a more comprehensive classification of the pathogenesis of tuberculous meningitis has been proposed by Donald et al.: [1]
A Rich focus is a tuberculous granuloma occurring within the cortex or meninges of the brain that ruptures into the subarachnoid space, causing tuberculous meningitis. [1] The Rich focus is named for Arnold Rice Rich, a pathologist at Johns Hopkins Hospital, who along with his colleague Howard McCordock first described the post-mortem finding of caseous foci within the cerebral cortex or meninges which appeared to predate the development of meningitis. [2] Prior to their research the prevailing view had been that meningitis occurred as a result of the dissemination of tuberculous bacilli associated with miliary tuberculosis and that these processes occurred at the same time.
More recently a more comprehensive classification of the pathogenesis of tuberculous meningitis has been proposed by Donald et al.: [1]