504 ^Journal of Comparative Neurology and Psychology. 



Thrombotic Softening of an Entire Hemicerebrum. 



No. 1909. O. B.; female; white; aged 69; nativity, U. S. Mental disease, 

 chronic melancholia with secondary dementia. 



Six days before the patient's death she had a general convulsion from which she 

 did not fully regain consciousness, followed the next morning by another, with 

 hemiplegia and loss of speech; after this she remained comatose until she died four 

 days later. 



Synopsis of Autopsy. — Arteries at base of brain sclerotic and tortuous; posterior 

 communicating artery of left side unusually large; posterior cerebral of the same 

 side small and impervious; anterior communicating artery small and impervious; 

 On the right side the vessels were of normal caliber except the posterior communi- 

 cating which was rather large. A clot had formed at the upper end of the left inter- 

 nal carotid artery, and as result of the above peculiarities of the circulation the 

 whole left hemicerebrum had undergone acute softening. 



The hemisphere was deeply reddened, extremely soft, and the cerebral veins 

 were engorged even to their smallest visible branches. It was in fact, practically a 

 hemorrhagic infraction of the whole hemisphere. The sinuses were not obstructed. 

 The softened hemisphere was generally swollen, presenting a marked contrast with 

 the right, which was moderately atrophied. (Fig. 10.) 



Anomalous Condition of the Basal Arteries. 



No. 1954. M. J. B.; female; white; aged 64; nativity, U. S. Mental disease, 

 chronic dementia. 



The patient had a history of cerebral hemorrhage occurring about six years before 

 her death. This resulted in partial paralysis of the right side, from which she suf- 

 fered when admitted to the hospital. Her last illness was a sudden attack of left 

 hemiplegia with evidences of disturbance or irritation of the motor region of the 

 left side of the brain. 



Synopsis of Autopsy. — The arteries at the base of the brain were extremely 

 sclerotic, calcified and anomalous. The left anterior cerebral was large; the ante- 

 rior communicating artery large; and the right anterior cerebral was small, thus the 

 main blood supply to the anterior cerebral region came from the left carotid. Both 

 posterior communicating arteries were unusually large; both posterior cerebral 

 vessels small, especially the right. The left superior cerebellar artery double; left 

 vertebral artery as large as the basilar; the right quite small, and the posterior 

 inferior cerebellar, received nearly all of the blood brought by the vertebral. 



A small aneurism had formed on the right middle cerebral artery at the point 

 of origin of the principal branches, and a large intra-cerebral hemorrhage had 

 occurred on this side from one of the lenticulo-striate arteries but the actual vessel 

 could not be determined. 



A horizontal section of the brain revealed an enormous hemorrhage of the right 

 side which had completely destroyed the basal ganglia and capsules and torn its way 

 into and filled the ventricles. On the left side there was a small brownish lesion 

 in the internal capsule just posterior to the angle, which was supposed to be the 

 remains of the former hemorrhage. The brain was oedematous and soft, and the 

 perivascular spaces were greatly enlarged; some general atrophy of the convolutions 

 of the surface. Other conditions found not important in this connection. 



