. Un traité sur les maladies nerveuses des enfants : pour les médecins et étudiants. à cette vue de Recklinghausen, et de l'accepter comme apartial explication, au moins, de l'occurrence fréquente de l'hémorragie. Parfois, bien sûr, expliqué par la plus délicate structure du sang-ves- 544 LES MALADIES NERVEUSES DES ENFANTS : sels chez les enfants par rapport à l'adulte. Mais il y a encore un autre strikingdifference entre ces apoplexies adultes et infantiles. Dans le themajority adultes des hémorragies se produisent à proximité de la capsule interne. Dans thechild ils se produisent dans le cortex ou à proximité, les hommes

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. A treatise on the nervous diseases of children : for physicians and students. to this view of Recklinghausen, and to accept it as apartial explanation, at least, of the frequent occurrence of hemorrhage. Somecases are of course explained by the more delicate structure of the blood-ves- 544 THE NERVOUS DISEASES OF CHILDREN: sels in children as compared with the adult. But there is still another strikingdifference between these infantile and adult apoplexies. In the adult themajority of hemorrhages occur in the vicinity of the internal capsule. In thechild they occur in or near the cortex, Mendel has shown that the greatestpressure is exerted in the branches of the middle cerebral artery, and thatany increase of pressure would naturally cause a rupture in one of these.We would have to seek some other explanation for the frequent occurrenceof cortical and meningeal hemorrhages, and perhaps they will be sufificientlyaccounted for by the more delicate structure of these vessels in children. Oc-casionally intra-cerebral hemorrhages, embolism, and thrombosis occur in. ^.r Fig. 145.—Section through Portion of Motor Cortex, removed by Dr. Gerster duringan Operation for Locahzed Epilepsy, associated with Old Left Hemiplegia in a BoyTwelve Years of Age. Specimen was stained according to Van Giesons method.The pia, P, which is greatly thickened and altered, dips down between two folds ofthe cortex, C. B, increased number of thickened small arteries ; just above, to theright, a large artery with thickened walls, H points to a recent clot. The line, a b, denotes the part of cortex examined under higher power and represented in Fig. 146. children in exactly the same manner in which they occur in the adult, andthey give rise to clinical symptoms in nowise different from those of ordinaryapoplexy. An interesting case of this sort I had occasion to observe in a boy, two and a half years of age, who after a simple attack of tonsillitis developedright hemiplegia with motor aphasia, w

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