Among the most difficult tasks confronting the physician is that of differentiating between operable and inoperable affections of the spinal cord. The symptoms of pain, of anesthesia and of hyperalgesia, of disturbances in the function of the bladder and the bowel are frequently misleading; and there is no motor disturbance characterizing disease of the spinal cord proper which may not be brought about as well by pressure on the cord of an adjoining tumor. The method employed by Ayer 1 brings greater certainty to bear on the differential diagnosis of subarachnoid block from disease of the spinal cord proper. It necessitates, however, the introduction of a needle into the cisterna magna and is therefore available only to the skilled surgeon. The injection of an iodized fat into the subarachnoid space in order to facilitate roentgen-ray examination, recently proposed by French neurologists,2 is likewise mainly by way of the cisterna
ROSETT J. A NEW METHOD OF DIAGNOSIS IN CERTAIN DISEASES OF THE SPINAL CORD. JAMA. 1925;84(6):423–429. doi:10.1001/jama.1925.02660320015006
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