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October 1940


Author Affiliations

New York

From the Department of Neurosurgery, the Jewish Hospital of Brooklyn.

Arch NeurPsych. 1940;44(4):879-885. doi:10.1001/archneurpsyc.1940.02280100181014

Resolution of intracranial gummas, as evidenced by roentgen study, is not uncommon. Alteration of the position of the calcified pineal body or of the pneumencephalographic picture attendant on diminution in size or disappearance of such lesions has been described. An example of the former was cited by Bailey.1 His patient showed improvement in symptoms, recession of papilledema and return of the pineal body to the midline three months after inauguration of treatment with bismuth and iodides. Paleari2 recorded an instance of marked cerebral ventricular shift in which the ventricles returned to normal position after the institution of antisyphilitic therapy.

The problem of intracranial gummas, however, is not invariably handled with such facility. When the neurosurgeon is confronted with evidence of intracranial hypertension, rapidly failing vision, advancing papilledema and a positive Wassermann reaction of the blood or cerebrospinal fluid, he cannot always temporize until a diagnosis is definitely established;

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