. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). ataxic,the arms, especially the right arm, are also ataxic, so much sothat he feeds himself with difficulty. Babinskis adiadococi-nesia is marked in the right arm. Speech is very thick andindistinct. Diplopia is marked and paresis of right third, ,seventh, fifth, ninth, tenth and eleventh nerves has developed. 20 Also some paresis of eighth nerve on the right side. Withinthe past few weeks the man has liad some nausea in themorning and headache has returned, but not nearly so severeas before
. Contributions from the Department of Neurology and the Laboratory of Neuropathology (reprints). ataxic,the arms, especially the right arm, are also ataxic, so much sothat he feeds himself with difficulty. Babinskis adiadococi-nesia is marked in the right arm. Speech is very thick andindistinct. Diplopia is marked and paresis of right third, ,seventh, fifth, ninth, tenth and eleventh nerves has developed. 20 Also some paresis of eighth nerve on the right side. Withinthe past few weeks the man has liad some nausea in themorning and headache has returned, but not nearly so severeas before the operation. Eye sight is excellent for distance. The question has been put to me several times whetherpalliative operation might be of benefit when the patientwith signs of brain tumor has suddenly fallen into Eussell, as already stated, is in favor of trephin-ing when respiration has ceased but the heart continuesto beat, even though the chances of saving life may beremote. Very frequently, in my experience, sudden death hasterminated tlie of brain tumor, especially. Fig. 1.—Showing the cerebellar position of upper limbs causedby a large tumor at the base of the brain displacing the cerebellum(Fig. 2). when the tumor is in the posterior cranial fossa. Thepatient may be no worse than he has been for months,and suddenly he becomes cyanosed, unconscious, possi-bly has convulsive movements and respiration ceases,but the heart continues to beat. It has seemed extremelydoubtful to me whether decompression would be advis-able under such circumstances. Death is almost cer-tain, and the physician who performs or recommends apalliative operation when the patient is at the point ofdeath is likely to be regarded by the relatives as havinghastened the fatal termination. Such operation, done ata more suitable time, I believe may materially lessen thedanger of these sudden and usually fatal attacks. 21 A patient with brain tumor, who had also been underthe care of
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