. The practice of pediatrics. ypes of cerebral malformation are of developmentalrather than of clinical interest. Meningocele, encephalocele, and hydrencephalocele are protrusionsof cranial contents through congenital gaps which persist between the bones of the skull. Suchdefects are most com-mon in the occipital andfrontonasal regions. When the protrud-ing sac consists onlyof the membranes sur-rounding the brain, itis called a meningocele;when a portion of thebrain itself is included,the tumor is called anencephalocele; and whenthe encephalocele con-tains ventricular fluid,a hydrencephalocele
. The practice of pediatrics. ypes of cerebral malformation are of developmentalrather than of clinical interest. Meningocele, encephalocele, and hydrencephalocele are protrusionsof cranial contents through congenital gaps which persist between the bones of the skull. Suchdefects are most com-mon in the occipital andfrontonasal regions. When the protrud-ing sac consists onlyof the membranes sur-rounding the brain, itis called a meningocele;when a portion of thebrain itself is included,the tumor is called anencephalocele; and whenthe encephalocele con-tains ventricular fluid,a hydrencephalocele. In microcephalus(see Fig. 62) the capac-ity of the skull is lessthan normal, and thebrain itself is abnormally small. This defective development has beenexplained by Virchows theory of premature ossification in the cranialbones, but, according to Sachs, is probably due to atrophic changes,which are the result of hemorrhage or inflammation affecting the brainand its membranes. If the latter be the true explanation of the de-. Fig. 61.—Meningocele. MALFORMATIONS OF THE BRAIN AND CORD 483 formity, any treatment of an operative character designed to allow brainexpansion by increasing the dimensions of the skull must promise little. Neither explanation is satisfactory. There is more than a prematureossification. The skull formation along the line of the sutures is many cases I have found at the line of the suture a distinct ridge, asthough nature had taxed herself to the utmost to unite the cranial the excessive ossification the bones of the skull generally are muchthicker than normal. Symptomatology.—The symptomatology is the same as describedunder Cerebral Palsy. The patients are almost always low-grade de-fectives. In subjects with microcephalus—microcephalic idiots—who surviveinfancy, symptoms of paralysis, lack of development of the special senses,and low intelligence are the rule. Craniectomy.—The operation of craniectomy, based upon the the
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Keywords: ., bookcentury1900, bookdecade1910, bookid39002, booksubjectchildren
