I n cushing's series 3 of 2,203 verified intracranial tumors, the meningiomas comprised 13.4 per cent. The incidence has been reported as somewhat higher by others (Olivecrona, 13 15.8 per cent; Craig, 16 14.9 per cent; Horrax, 10 19 per cent). Despite its frequent occurrence among brain tumors, the meningioma is rarely seen as a multiple growth unless one includes those cases of centralized neurofibromatosis, a manifestation of von Recklinghausen's disease, in which the dura is often studded with innumerable small meningiomas. Cushing and Eisenhardt 3

and work of Harvey Cushing, we must for a moment look at the status of this newly launched specialty up to the time when he appeared upon the scene. Not until the era of anesthesia and antisepsis, and particularly not until the beginnings of cerebral localization ( circa 1870) had operations upon the brain and spinal cord advanced appreciably since medieval or ancient times. Soon after this, in the middle eighties of the nineteenth century, a very few, and very occasionally successful, operations upon brain tumors, brain abscesses and spinal cord tumors were

. Chemical, clinical and immunological studies on the products of human plasma fractionation. I. The characterization of the protein fractions of human plasma. J. clin. Invest. (In press) Cohn , E. J., Oncley , J. L., Strong , L. E., Hughes , W. H., and Armstrong , S. H., Jr. Chemical, clinical and immunological studies on the products of human plasma fractionation. I. The characterization of the protein fractions of human plasma. J. clin. Invest. (In press) 3. Cushing , H. The control of bleeding in operations for brain tumors. With

hemostatic agent in neurosurgery: clinical and pathological studies. J. clin. Invest. (in press). 5. Cushing , H. The control of bleeding in operations for brain tumors. With the description of silver “clips” for the occlusion of vessels inaccessible to the ligature. Ann. Surg. , 1911 , 54 : 1 – 19 . Cushing , H. The control of bleeding in operations for brain tumors. With the description of silver “clips” for the occlusion of vessels inaccessible to the ligature. Ann. Surg. , 1911, 54: 1–19. 6. Harvey , S. C

are found among the tumor cells which are not in rosette arrangement. Mallory's phosphotungstic acid-hematoxylin stain (×1300). COMMENT When dealing with brain tumors, as well as with other neoplasms, a definite correlation can usually be made between the clinical findings and the pathological characteristics, but a certain number of instances must be expected in which variations exist. The patient described in this paper presents many complex and bizarre problems in relating the clinical manifestations to the type of tumor finally obtained for

nucleus of the sixth nerve (eminentia teres). Adjacent and posteriorly are the expanded parts of the posterior columns named the clavus and cuneus. Regardless of our knowledge of the anatomic arrangement in this area, the neurophysiologic mechanisms involved are difficult to understand. Brain tumors, other than cerebellopontine angle tumors, do not play an important part in nerve deafness, although it does occur with midbrain lesions, 6 usually late in the course of the disease. Studies by Craig and Kernohan, 2 Gibbs, 4 Drury 3 and Northington 5 fail to mention

few days later was diagnostic of an acoustic neuroma. Merritt 8 has stated that acoustic neuromas, of all the brain tumors, are most prone to produce elevation of the protein content of the fluid obtained by lumbar puncture. Nine of our patients had the procedure performed here or elsewhere, and all showed proteins of 100 mg. per cent or more. In the following case the protein elevation gave us the final clue between an acoustic neuroma and an intrapontine lesion. Case 3 . L. S., a 63-year-old white woman, was admitted to the New England Deaconess Hospital on

perimetry by Traquair, 2 it is thought worth while to present the following case in illustration. CASE REPORT A twenty-four year old man was referred with the diagnosis of brain tumor. His complaint was severe headache for one and one-half months. Five years previously he had been in an automobile accident and had been unconscious for one minute but had no persistent symptoms. Two and one-half years before admission he suddenly noticed blurring of vision in the right eye whenever he looked at a target, and this condition persisted unchanged, so that he began

epileptic seizures than that located in the posterior portion. This is not only true of trauma, but of brain tumors. 19 Surgery was performed in all of the cases, except one. This patient had a depressed fracture at birth and developed seizures twenty-four years after injury. From these facts, it is quite apparent that early surgery is not always instrumental in preventing seizures. It would definitely appear as if the original damage to the brain, or the late formation of adhesions, cysts, etc., are the responsible factors. The depth of fractures in 3 (18.7 per cent

: Lewis' Practice of Surgery. Hagerstown, Md. : W. F. Prior Co., Inc. , 1932 , 12 : 647 – 653 . Dandy , W. E. Congenital cysts of the cavum septi pellucidi (fifth ventricle) and cavum Vergae (sixth ventricle). In: Lewis' Practice of Surgery . Hagerstown, Md.: W. F. Prior Co., Inc., 1932, 12: 647–653. 3. Globus , J. H. , and Kuhlenbeck , H. The subependymal cell plate (matrix) and its relationship to brain tumors of the ependymal type. J. Neuropath. exp. Neurol. , 1944 , 3 : 1 – 35 . Globus , J. H., and