456 THE PINEAL ORGAN 



Second Operation. — On 5th November, 1931, a right subtemporal decom- 

 pression was carried out under local anaesthesia. Considerable intracranial 

 pressure was found. The patient stood the operation well, but afterwards 

 became more drowsy and gradually got weaker. He suddenly collapsed and 

 died on 21st November, 193 1. He had been running a high temperature for 

 three days. The wound had quite healed and was healthy. 



Pathology. — A post-mortem examination was carried out by Dr. Carnegie 

 Dickson. The body was that of a well-nourished, well-developed young adult 

 male, with little of note externally except that the figure showed a tendency to 

 the female type. There was marked general flattening of the convolutions, 

 more especially of the left hemisphere, which appeared to be slightly larger 



Fig. 307. — Case 4. Radiograph after Ventriculography, showing Dilated 

 Lateral Ventricles and Area of Pineal Tumour just beneath the 

 Corpus Callosum. 



than the right. The larger surface veins were somewhat dilated and the 

 Pacchionian bodies about the vertex were numerous and prominent. Over the 

 central portion of the base, e.g. over the pons and the interpeduncular space 

 and dilated infundibulum, there was some thickening of the pia arachnoid. 



On horizontal section of the brain at the level of the upper surface of the 

 corpus callosum, the lateral ventricles were found to be very considerably 

 dilated, especially the left, and the section at this level passed through a pearly 

 " epidermoid " or " cholesteatomatous " tumour to the left side of the middle 

 line, just posterior to the central point of the hemisphere, and occupying 

 roughly the normal position of the left optic thalamus, which was displaced 



