The Treatment of General Paresis by the Intracistern Route

To be conservative in the adoption of new procedures is advisable. This is especially true of the clinical application of puncture of the cisterna magna for diagnostic and therapeutic purposes, owing to the proximity of the medulla oblongata. Wegeforth, Ayer and Essick1in their pioneer work have demonstrated the practical value of puncture of the cisterna cerebellomedullaris and the ease with which it is done, after careful anatomic studies on the cadaver. Ayer2reports fortythree punctures and says cistern puncture is indicated in the following conditions: (1) spinal subarachnoid block following meningitis; (2) combined with lumbar puncture for irrigation of the subarachnoid space; (3) as a route for injection in epidemic meningitis; (4) in conjunction with lumbar puncture in diagnosis of cord compression. The object of this paper is to discuss puncture of the cisterna magna in the treatment of general paresis. A total number of 250 punctures