Encephalography in Cases With Fixed Lesions of the Brain

Abstract

Encephalography involves the removal of cerebrospinal fluid and its replacement by air. This is definitely a formidable procedure and is probably uniformly followed by a meningeal reaction. In this paper we report our experience with this admittedly severe method of study as it was applied to a group of children with supposedly fixed lesions of the central nervous system. We believe that the method reveals information of great value, and that as a result treatment can be carried out more promptly and more adequately in many cases.It is unnecessary to discuss the literature in any detail, since Pancoast and Fay summarized it in a recent article.1 The daring and effective investigations of Dandy are of course fundamental.Two major methods of introducing air into the spaces usually occupied by fluid have been used: the introduction into the ventricles by direct puncture and the introduction through a needle in the lumbar subarachnoid space. X-ray films taken after direct puncture of the ventricles are always called ventriculograms. After lumbar puncture the air is likely to reach the general subarachnoid space as well as the ven¬ tricles, and the resulting film is often called an encephalogram. In addition, certain Hellenic enthusiasts have evolved the world pneumorrhachicentesis for the procedure. In this paper we follow Pancoast and Fay in referring to encephalograms.