. Alienist and neurologist. . in itsentirety, that one may be better guided to the proper interpretation and correlation ofclinical facts. That some difficulty in differentiating at times the post-epilepticconfusional state not infrequently found following a grand-mal attack, from a confusionalstate sometimes observed following a concussion of the brain or a vascular crisis,hemorrhagic in type, needs, I feel, no special elaboration. Without a history, I daresay, such a differentiation may at times be extremely trying. That the difficulty isgreatly increased where the possibility of two such co
. Alienist and neurologist. . in itsentirety, that one may be better guided to the proper interpretation and correlation ofclinical facts. That some difficulty in differentiating at times the post-epilepticconfusional state not infrequently found following a grand-mal attack, from a confusionalstate sometimes observed following a concussion of the brain or a vascular crisis,hemorrhagic in type, needs, I feel, no special elaboration. Without a history, I daresay, such a differentiation may at times be extremely trying. That the difficulty isgreatly increased where the possibility of two such conditions, so grave as the onesnow under consideration, are likely to be met with in the same individual likewiseholds true. Here the value of untoward ocular manifestations, cranial nerve lesions,increared intracranial pressure, blood tinged spinal fluid, and the hemiplegic statein such a differentiation are all points, the absence or presence of which are ofundoubted diagnostic significance. 922 Equitable Page Two Hundred Three ETIOLOGY AND PATHOLOGY OF SCLEROSIS OFCEREBRAL VESSELS. By HOWARD T. CHILD, M. D., Pathologist, State Hospital, Norristown, Pa. N the vast majority of cases upon which a post mortem is done,sclerosis of the cerebral vessels is found. Before taking up thecauses of this condition, let us for a moment review the bloodsupply of this region. The large arterial trunks are representedthrough the basilar artery which sends its large branches, thearteriae cerebelli superior and the arteriae profunda cerebri, to thepons and brain stem. The artery of the fossae of Sylviussupplie; the center of the brain through the arteria corpus callosiand the lenticular artery. The arteries given off at right angles from the fossae Silvaeare end arteries, that is, the brain tissue surrounding them hasno possibility of a collateral blood supply. This explains whydisease of the basilar arteries presents the same clinical symptoms,namely, hemiplegia on one hand
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