AMAarchives of neurology & psychiatry . Fig. 5.—Condition ten months after operation (for comparison with Fig. 1). CUSHIXG—CRAXIAL HYPEROSTOSES 145 was fully exposed. Removal of the sphenoid wing was carried inward to theregion of the left anterior clinoids in the depths of the sylvian groove. At the bottom of the bone defect thus made, roughened dura was exposedcovering practically the entire tip of the temporal lobe. There was no cer-tainty as to what underlay this thickened dura, whether an endothelioma ofthe plaque variety or a rounded tumor. The membrane was opened at theupper margin of t
AMAarchives of neurology & psychiatry . Fig. 5.—Condition ten months after operation (for comparison with Fig. 1). CUSHIXG—CRAXIAL HYPEROSTOSES 145 was fully exposed. Removal of the sphenoid wing was carried inward to theregion of the left anterior clinoids in the depths of the sylvian groove. At the bottom of the bone defect thus made, roughened dura was exposedcovering practically the entire tip of the temporal lobe. There was no cer-tainty as to what underlay this thickened dura, whether an endothelioma ofthe plaque variety or a rounded tumor. The membrane was opened at theupper margin of the bone defect where it was evidently normal in appearanceand the edge of a flat endothelioma was seen. The incision in the membranewas then carried around between normal dura and the edge of the tumor, givingthe latter a free margin of a few Figs. 6 and 7.—Photographs (natural size though considerably shrunken byfixation) of major portion of tumor; seen on edge in upper figure and fromthe inner dural surface in the lower figure. It is quite possible that at the very depth of the sylvian cleft where thefield became somewhat inaccessible, some portion of the involved bone anddura may have been left behind. The dura was so vascular that silver clips were placed on its margins forpurposes of hemostosis as the incision to outline the growth was being situation and extent of the flat tumor is consequently well shown in theroentgen-ray picture subsequently taken (Fig. 3). The operation, though a prolonged one. was well borne. Convalescence wasuneventful (Fig. 4), and at the time of her discharge the exophthalmos andedema of the orbit had largely disappeared. At the present writing, ten months later, she remains free from symptoms ;there is no indication of any tumor growth from the possible remaining frag-ment; the ex
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