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September 29, 1917

CEREBRAL SPASTIC PARALYSIS DUE TO HEMORRHAGEA FURTHER REPORT OF THE FIRST SIXTY-FIVE CASES OF CRANIAL DECOMPRESSION FOR SELECTED CASES

JAMA. 1917;LXIX(13):1056-1057. doi:10.1001/jama.1917.02590400016004
Abstract

The patients were carefully selected, and only those with signs of persistent intracranial pressure were chosen, this constituting less than 25 per cent. of those examined. Ophthalmoscopic examination revealed dilated retinal veins and blurring of the optic disks; in the later cases, these findings of increased pressure have been confirmed by the measurement of the cerebrospinal fluid at lumbar puncture by the use of the spinal mercurial manometer. In all of the cases there was a history of prolonged and difficult labor, most of them being instrumental deliveries. A negative Wassermann test of both blood and spinal fluid was obtained in every case except one. No selection was made as to age, spasticity or mental deficiency. Microcephalic children, cases of agenesia (so-called Little's disease), and those due to meningo-encephalitis were naturally excluded as nonoperable, there being no increased intracranial pressure.

The pathologic condition, as found at operation and and post

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