. Medical and surgical therapy. an intra- orjuxta-nervous character, eitherencapsuled within the nerve or jut-ting out on one of its sides (fig. 14). These fibromata are of two kinds:the one are pure neuromata, formed of nervous fibres,and the others have a fibrous core. The first kind aresituated in the interior of the nerve ; they have asoft consistence, and should be left alone (fig. 15). Fig. 12. Lateral pseudo-neu-roma with smalllateral notch. The pseudo-neuro-ma, which is moresalient on the rightside, shows at thislevel asmall lateralnotch. Of thefibres which wereon their way to the
. Medical and surgical therapy. an intra- orjuxta-nervous character, eitherencapsuled within the nerve or jut-ting out on one of its sides (fig. 14). These fibromata are of two kinds:the one are pure neuromata, formed of nervous fibres,and the others have a fibrous core. The first kind aresituated in the interior of the nerve ; they have asoft consistence, and should be left alone (fig. 15). Fig. 12. Lateral pseudo-neu-roma with smalllateral notch. The pseudo-neuro-ma, which is moresalient on the rightside, shows at thislevel asmall lateralnotch. Of thefibres which wereon their way to theupper lip, someturn back, thusforming a smallneuroma, otherscurl in, pushedaside by the scle-rotic tissue, andeventually join thelower end. (AfterPierre Marie andFoix.) 248 TREATMENT AND REPAIR OF NERVE LESIONS The second type form hard swellings on the surfaceof the nerve. According to P. Marie and Foix, the best plan is toleave them alone, since the cicatricial tissue whichreplaces them when they have been excised is equally. Fig. 13.—Lateral pseudo-neuroma with small lateral notch. a, nerve fasciculus crossing the injured region ; h, sclerotic mass enclos-ing and thickening the nerve ; c, small notch which has determinedthe lateralisation of the pseudo-neuroma. (After Pierre Marie andFoix.) hard, and occasionally presents an even greater obstacleto the passage of nerve fibres. Simple induration of the nerve.—This lesion corre-sponds clinically in the vast majority of cases to thosepainful affections chiefly found in the median andsciatic, which M. and Mme. Dejerine and J. Mouzoncall the syndromes of irritation. The nerve shows an induration which often canonly be felt but occasionally can be seen, in which casethe nerve is slightly swollen, and has a greyish tint, LESIONS OF INJURED NERVES 249
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