Neurology. — "A partial foetus removed from, a child." By Prof. 

 C. Winkler. 



(Communicated at the meeting of June 30, 192.3). 



A few months ago a child of nearly thi-ee inotUhs, was bionght 

 in my clinic, having a fluctnating tumour in the neck and a not 

 very intensive internal hydroce{)halus. 



Apparently it suffered from spina bifida, as the transverse proces- 

 sus of the 2d and 3d cervical vertebrae stood far apart and the 

 processus spinosi were missing. The examination of the tumour made 

 it probable that a myelocystocele might be found in it. 



For the rest this healthy child had normal breathing, responded 

 to pin-pricks with mimic facial expressions and spontaneously moved 

 its four extremities. 



Tiie tumour, filled up with liquor, was opened by Dr. Waller. 

 He found in the middle of the fluid a strongly vasculated stalk, 

 nearly 1 c.M. in diameter, connecting the deep tissues in the mid- 

 line with the external wall of the tumour-cyst. After nnderbinding 

 the stalk in the depth, he removed stalk and cystic tumour. In a 

 week the child recovered. As 1 saw it again, six weeks after the 

 operation, it appeared to be a rather normal child of circa five months 

 of age. 



The removed specimen was given to me. 



A section made tlirough the middle of the stalk proved, that it 

 was a spinal cord surrounded by an intensely vasculated membrane 

 (fig. la). In this spinal cord the colnmna posterior had ^j— \*^ 

 disappeared and the dorsal wall of the central canal was i! jj 

 open. The form of the central canal was as this figure shows. " 



The lateral, the anterior column and the grey matter were easily 

 recognisable. In the lateral column the area of Lissaijer, the spino-cere- 

 bellar tracts and the surroundings of the grey substance are myeli- 

 nisated. In the anterior funiculi was seen a strongly marrowed 

 commissura anterior, and the tecto-spinal path has also gained 

 marrow. Both, not medullated, pyramidal tracts are recognisable. 



The substantia Rolando is strongly developed. The anterior horns 

 contain atrophic large cells. 



