. Some points in the surgery of the brain and its membranes . 1901. Autopsy.—Only the brain was examined. The right hemisphere weighed 551grammes j the left, 521 grammes. This difference was due to atrophy affecting thehemispheres unequally ; the patient was not left-handed. The meninges at the basewere slate-coloured. The pia was adherent to the cortex in places over both frontallobes, but these adhesions were of no great depth or extent. In both temporal lobesthere were scattered patches of slight ulceration, but in the left hemisphere inaddition there was a focus of intense meningo-encephal
. Some points in the surgery of the brain and its membranes . 1901. Autopsy.—Only the brain was examined. The right hemisphere weighed 551grammes j the left, 521 grammes. This difference was due to atrophy affecting thehemispheres unequally ; the patient was not left-handed. The meninges at the basewere slate-coloured. The pia was adherent to the cortex in places over both frontallobes, but these adhesions were of no great depth or extent. In both temporal lobesthere were scattered patches of slight ulceration, but in the left hemisphere inaddition there was a focus of intense meningo-encephalitis affecting the posteriorthird of the first temporal convolution and the convolutions of the posterior inferiorpart of the parietal lobe behind the intra-parietal sulcus. In this situation the lesionextended in depth as far as the white substance ; the whole thickness of the greymatter came away adherent to the pia. On the right side there was a symmetricallyplaced, but less intense lesion, not reaching the white matter. 352 SOME POINTS IN THE SURGERY. Fig. 185.—Sketch of operation for subcortical tumour (sarcoma), growing in thecentrum ovale beneath the cortex of the upper part of the precentral convolu-tion and the superior parietal lobule. (Beevor and Ballance.) R, fissure of Rolando + place where cortex was thinned and ruptured duringpalpation. The continuous line is the line of incision of cortex for removal oftumour ; outside this the vessels have been ligated with fine silk. Female, aged 30. Illness commenced twelve months salient points of the case were as follow : — 1. The gradual onset of the paralysis, involving successively ankle, knee, hip, hand, elbow, shoulder, speech. 2. The syndrome symptoms were present—headache, vomiting, and optic neuritis. 3. The mental condition deteriorated. 4. Partial loss of sensation in the right limbs. Patient never had a fit, and there was no tenderness of cranium. Muscularsense was lost in the right upper extre
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