Examine the convexity, comparing hemispheres, noting convolutions
and sulci (size, number, symmetry, etc.) Atrophy of the gyri is
shown by increased width of sulci and the narrower, sharper gyral
apex. With increased intracerebral pressure the gyri are flattened
and broader, and the sulci smaller. Note color and consistence
of cortex, adhesions with pia, areas of fluctuation, induration,
depressions, yellow softening, recent and old hemorrhages, effects
of trauma, tumors, tubercles, gummata, etc. Examine median surfaces,
note arching of corpus callosum. On section of the brain note _color_
(pale in anæmia, red in capillary hyperæmia; hemorrhages, areas of
softening, tumors, tubercles, gummata, sclerotic areas, abscesses,
etc., all show color variation from the normal gray or white);
_consistence_ (soft in degeneration and abscess, hard in sclerosis),
_moisture_ (normally is moist-shining; moisture increased in œdema,
inflammation, abscesses, soft tumors, recent degenerations; dry in
old caseous tubercles and gummata, and in anæmia), _blood-content_
(number of bleeding-points, distinguish from punctate hemorrhages),
_character of cut surface_ (normally smooth, sclerotic areas,
abscesses and areas of softening are uneven and depressed, hard
tumors and sclerotic blood-vessels are elevated above the surface).
The absolute and relative size of cortex and medulla, and the
distinctness of the boundary between them, should be noted.
Hemorrhages may occur in any part of the brain, and may be large
or small. Rupture into a ventricle is always fatal. The large
hemorrhages are due to rupture of a diseased artery; small punctate
hemorrhages throughout cortex are usually embolic (fatty embolism).
Old hemorrhages are brownish in color (pigment). Areas of softening
are usually the result of embolism, thrombosis or sclerosis. They are
usually yellow, yellowish-white or brownish-yellow or red.
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