Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . of parts beneath the clot. Otherwisethe cortex is rendered simply ansiemic at the seat of pressure. It mayregain its function, in such a case, when the pressure is relieved by theuse of trephine or the gradual absorption of the clot. Structural changes in the motor convolution are almost invariablyfollowed by a descending sclerosit^ of those fibres that are anatomicallyassociated with the cortical cells destroyed. This scleros
Lectures on nervous diseases from the standpoint of cerebral and spinal localization, and the later methods employed in the diagnosis and treatment of these affections . of parts beneath the clot. Otherwisethe cortex is rendered simply ansiemic at the seat of pressure. It mayregain its function, in such a case, when the pressure is relieved by theuse of trephine or the gradual absorption of the clot. Structural changes in the motor convolution are almost invariablyfollowed by a descending sclerosit^ of those fibres that are anatomicallyassociated with the cortical cells destroyed. This sclerosis can often betraced into the substance of the spinal cord. In this way the motorfunction of Tiircks columns and of the crossed pyramidal tracts in thespinal cord (Fig. 29) has been established beyond dispute. CEEEBEAL HEMOREHAGE. 255 The following simple diagram will possibly aid the reader in master-ing the more essential anatomical facts that pertain to motor paralysisof cerebral origin. It is designed purely for the purpose of teaching,and must not be construed as a representation of the parts in theirproper relations to vdc\\ other:— Mor^Sff^lT^^^^^-ZJ^.. \lElfJU OPBKSe< or ( M£M/SPM^RES /i£6/OJf Off THESPJHML COMO Dmscr pyffJUifriDML cjiosssd jvxam/dml F-/BRES r/B/tES Fig. /9.—A Diagram Designed by the Author to Illustrate the Effects of CorticalAND Non-cortical Lesions of the Cerebrum. It will be perceived that the motor convolutions of the cortexcontain special centres of motion (6\). From these centres fibres of theso-called ?? pyramidal tracts can be traced through the medullary centreof each hemisphere (the white matter of the cerel)rum) to enter the posteriorhalf of the internal capsule that passes between the corpus striatum(G. S.) and the optic thalamus (0. T.). At the level of the base of thecerebrum these fibres are continued downward successively through thecms cerebri, the pons varolii, the medulla, and into the spinal cord. At 256 LECTl KES
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