AMAarchives of neurology & psychiatry . ne werenormal. Operation.—Feb. 3. 1921, Dr. Gushing made an osteoplastic exploration ofthe left hemisphere. A temporal lobe cyst was extirpated. Ether anesthesiawas used. An osteoplastic flap was turned down with its base low in the left temporalregion. The bone flap showed evidence of pressure erosion, the dura was quitetense and a subtemporal bone defect was made. The dura was opened over the temporal lobe which protruded markedly,palpation showing what was unmistakably a cyst. An incision through the HORRAX—CHOLESTEA TOM AS 273 second temporal was car
AMAarchives of neurology & psychiatry . ne werenormal. Operation.—Feb. 3. 1921, Dr. Gushing made an osteoplastic exploration ofthe left hemisphere. A temporal lobe cyst was extirpated. Ether anesthesiawas used. An osteoplastic flap was turned down with its base low in the left temporalregion. The bone flap showed evidence of pressure erosion, the dura was quitetense and a subtemporal bone defect was made. The dura was opened over the temporal lobe which protruded markedly,palpation showing what was unmistakably a cyst. An incision through the HORRAX—CHOLESTEA TOM AS 273 second temporal was carried down to the wall of the cyst, and its upper polewas fixed with pledgets of Zenkers solution until it was stiff enough to small needle was then inserted into the cyst, but through this nothing couldbe withdrawn by suction. The usual l)rain needle was then inserted and acurious, grumous, dirty fluid was removed, immediate examination of whichshowed fatty cells. The remainder of the fluid as it adhered to the tube became. Fig. 4.—Crescentic shadow above the sella turcica, shown by the roentgeno-gram in Case 1. stiffened, much like the cooling of melted fat. The fluid was thick and about 40 were collected, although the cyst probably contained twicethat amount as much of it was lost and the rest evacuated subsequently. The cyst when emptied was found to have a delicate vascularized liningmembrane. A curious fragment of tissue, quite loose, saucer shaped, about1 cm. in diameter and cm. in thickness, was lifted out of the cavity, thesource of this fragment not being apparent. The cyst wall was carefully fixed 274 /il<CHl\-ES OF SEVROLOGY AND ISYCIIIATRV with Zenkers fluid until it liecame stiffened and puckered, then l)y filling thecavity full of cotton, it was possible by slow dissection to remove the entirecyst wall, though in the process it was somewhat shredded. The bone flapwas then replaced. Microscopic Examination.—The cyst contain
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