. Manual of operative surgery. 11 { 4. Fig. 30.—Showing denudation of suboccipital region: exposure of foraminal field by reflectionof flaps: primary bone openings. {Cushing, Tumors of Nervus Acusticus.) When decompression is alone the object sought, the wound may now beclosed. If there is any doubt of the diagnosis, compare the two hemispheresfor dijBferences of tension, of form, or of vascularity. An intracerebellar cystcan usually be detected by palpation; an involvement of one hemisphere ratherthan the other by displacement of midline structures. If it is believed that acerebello-pontile a
. Manual of operative surgery. 11 { 4. Fig. 30.—Showing denudation of suboccipital region: exposure of foraminal field by reflectionof flaps: primary bone openings. {Cushing, Tumors of Nervus Acusticus.) When decompression is alone the object sought, the wound may now beclosed. If there is any doubt of the diagnosis, compare the two hemispheresfor dijBferences of tension, of form, or of vascularity. An intracerebellar cystcan usually be detected by palpation; an involvement of one hemisphere ratherthan the other by displacement of midline structures. If it is believed that acerebello-pontile angle lesion is present, slight pressure with a spoon spatula 32 THE SKULL AND THE BRAIN on the cerebellar hemisphere (Fig. 31) gives access to the region, providedthat the margin of the mastoid has been included in the cranial defect. The sigmoid sinus is first brought into view and at a varying distancebeyond it, the arachnoid attachment or an encysted collection of fluid withinthe arachnoid, is ecountered. On opening the cyst the
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