9. =Ventricles.= Contain about a teaspoonful of clear fluid. This
may become purulent, cloudy, hemorrhagic, fibrinous. Note size of
ventricles and horns. (Fluid increased and ventricles dilated in
hydrocephalus.) Character of ependyma normally gray-red, delicate;
may be pale or red, indurated, thickened, roughened (chronic
ependymitis), hemorrhagic, etc. Compare floors of lateral ventricles
as to symmetry (corpus striatum large in hemorrhages), color, etc.
Adhesions are found most frequently in posterior horns. A fine
granulation of the ependyma is caused by miliary tubercles. Large
solitary tubercles may be found in the ventricles. Do not mistake
postmortem softening of ependyma for pathologic changes. In the third
ventricle note the presence of any abnormal contents, character of
wall, symmetry of corpora quadrigemina, etc. Look for same changes in
fourth ventricle as in lateral. Lining is gray-white and delicate;
floor should be gray-white, firm, and show anatomic structures. Gray
sclerotic areas are often present in floor. Solitary tubercles,
tumors (glioma, neuroepithelioma, gliosarcoma, sarcoma), dermoids and
cysticercus-cysts may be found here. Examine aqueduct of Sylvius for
abnormal contents.
10. =Chorioid Plexus.= The tela chorioidea is normally delicate and
translucent. Note color (red, pale, cloudy), swelling, purulent
infiltration, condition of blood-vessels, tubercles, etc. Psammoma,
sarcoma, papillary epithelioma, carcinoma, fibroma, angioma,
cholesteatoma, cysticercus and echinococcus may be found in the tela
and plexus. Cysts due to œdema are very common, also aneurismal
dilatations of the vessels. In cases of hydrocephalus the veins of
Galen should be examined for thrombi or compression from without. In
acute hydrocephalus the plexus is deep red; hyperæmic, its vessels
distended with blood.
11. =Pineal Gland.= The most common pathologic findings are:
psammoma, adenoma, teratoma, sarcoma, formation of cysts (hydrops
cysticus glandulæ pinealis), hypertrophy, abscess (purulent
meningitis), metastatic tumors. In all cases of giantism especial
attention should be paid to the pineal gland as well as to the
hypophysis.
12. =Cerebral Ganglia.= Color, consistence, moisture, blood-content,
hemorrhage, degeneration, sclerosis.
13. =Peduncles.= As above.
14. =Cerebellum.= Cerebellar cortex is 2 mm. thick, grayish-red
in color. Note irregularities in thickness, color, consistence,
blood-content, moisture. Compare hemispheres. White substance
should be shining and moist. Abscesses, tubercles (solitary or
conglomerate), gummata and neoplasms are the most common pathologic
conditions.
15. =Pons.= Consistence firm normally. Note blood-content, relation
of white and gray stripes, hemorrhage, degenerations, cysts,
neoplasms, etc.
16. =Medulla.= Color grayish-white, consistence firm. Note
blood-content, hemorrhages, degenerations and cysts (syringomyelia).
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