File:A treatise on the nervous diseases of children, for physicians and students (1905) (14598175717).jpg

Identifier: treatiseonner00sach (find matches)
Title: A treatise on the nervous diseases of children, for physicians and students
Year: 1905 (1900s)
Authors: Sachs, Bernard, 1858-1944
Subjects: Nervous system Children
Publisher: New York, W. Wood and company
Contributing Library: The Library of Congress
Digitizing Sponsor: The Library of Congress

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upon a second time, and anopening similar to the first was made in the opposite half ofthe skull. The child died from shock four hours afterthe operation was finished. Figure 131 is inserted to show tne condition of the skull*after the second operation. It will be seen at first glancethat the original opening that was made became very muchsmaller after four months; that a tense fibrous tissue wasformed over this opening, and that therefore four monthsafter the initial operation the brain was not under condi-tions much more favorable than those which preceded the *This skull was demonstrated by Dr. A. Jacobi, at the International Congress, heldin Rome, 1894. In the last ten years the author has not advised this operation. 510 THE NERVOUS DISEASES OF CHILDREN. first operation. I would therefore conclude from my ownexperience * that Lannelongues operation is not likely per-manently to increase the intra-cranial capacity, and further-more, that operations upon young children are extremely
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Fig. 131.—Skull of a Child Two Years of Age, showing (on the left of the figure) theNarrowing of the Opening Made According to Lannelongues Method Four MonthsPrevious to Death. Death ensued four hours after second operation. dangerous, the children often dying from shock, or fromthe loss of blood. If we wish to utilize Lannelongues idea it will be betterto make a circular .opening over that part of the brainwhich from the symptoms in the case would appear to bedeficient. In children whose frontal lobes are stunted ingrowth, circular openings in the frontal or in the parietalbones would give a very large measure of relief, and I am * Rourneville, Jacobi and almost every one else have come to similar conclusions. DEFECTIVE DEVELOPMENT OF THE BRAIN. 511 confident that if the operation is entirely aseptic cerebralhernia need not be feared. The bone should not be re-placed, but it will be well to provide such children withsome form of external protection, or else the danger of di-rect in

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