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Plate XI.
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Carswell's 1838 Characterization of the compartmentation of a large paraventricular cerebral lesion according to a major cerebral vessel involvement:

Softening inside a cerebral hemisphere from arterial obstruction (a, lateral ventricle laid open; b, thalamus; c, corpus striatum; the upper half of the latter central cerebral nucleus is, corresponding to the ramifications of two smaller, obliterated arteries (d), converted into a soft pulp).

Differentiation from Multiple Sclerosis:
Contrary to the surging up of "Dawson's fingers" directly off of the ventricular border, periventricular lesions caused by arterial obstruction, in keeping with the local arteries' patterns of ramification, characteristically either bluntly abutt onto, or end at a certain distance from, the cerebral ventricles.


Historical Relevance:
This drawing inaugurated a progressive refinement in the delimitation of different cerebral (and spinal) vascular territories and of the corresponding cerebral (and spinal) lesion patterns, thus paving the way to a clearer discrimination and understanding of the genesis of the diverse vessel-related damages to brain and spinal cord.

© Dr. F. Alfons Schelling, M.D.