File:A manual of diseases of the nervous system (1892) (14596936418).jpg

Identifier: manualofdiseases00gowe (find matches)
Title: A manual of diseases of the nervous system
Year: 1892 (1890s)
Authors: Gowers, W. R. (William Richard), 1845-1915
Subjects: Nervous System Diseases Nervous system
Publisher: Philadelphia : Blakiston
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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cavity has extended into each posterior horn almost up to thesurface of the cord, in part by a breaking down of tissue, because the membranelimiting the enlarged canal remains undestroyed. In E, still at the junctionof the dorsal and lumbar regions, the cavit.v has receded from the left horn. InF, the division of the cord has taken place, not in the direction of the cavity inthe horn (which is filled up), but in the middle line, at or close to the medianseptum. In G, a wider separation of the posterior columns has taken place, and acavity has formed on the right side, which extends into the horn, and almost cutsofEthe posterior column. In H, the cord is spread out and formed part of the wallof the sac. The posterior nerve-roots (p r) mark the position at which theposterior horn come s to the surface. The grey matter is in many parts atrophiedand translucent, and, in H, contains many large vessels. The septal lobulation onthe surface of the cord is greater than normal. SPINA BIFIDA 583
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584 SPINAL COED. syringomyelocele are both rare; the common form is meningo-myelocele, in wliich the cord, altered or intact, extends within the sac.The Clinical Societys Committee found that this was the condition in62 per cent, of the cases in which there was an external tumour. Thelower part of the spinal cord is generally adherent to the posteriorwall of the sac, where its traction often causes a depression on thesurface, always at the membranous area, which, as already mentioned,is generally to be observed in the upper portion. The cord may againbecome free, and extend downwards in the cavity, or it may beflattened, expanded, and lost in the wall, of which its tissue reallyforms an inner layer. In this layer there is no distinction of grey andwhite substance. In either case, the lower nerves arise in the wall, andpass, first in this, and then forwards, across the cavity, to their fora-mina of exit. The arachnoid always extends into the sac-, and thefluid is that contained within

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