Similar expectant treatment is generally advised with regard to the extensive subpericranial hæmatomata, but as infection of the clot may take place, and as its resolution invariably requires a considerable period of time--often many weeks--more active measures can be adopted. The region of the hæmatoma is carefully shaved and cleansed, and, under local anæsthesia, a small incision made through the scalp, the clot squeezed out, and firm pressure applied. Under this form of treatment the patient is well within a few days. =Intracranial birth-hæmorrhages.= Attention was first drawn to the question of intracranial birth-hæmorrhages by Little, who showed that a history of difficult labour could be obtained in a large percentage of cases in which children in after-life suffered from uni- or bilateral spastic paraplegia; hence the name, ‘Little’s disease’ or birth palsy. Further information was supplied by Sarah MacNutt, and the whole question was fully investigated by Harvey Cushing. In all cases a history of difficult and protracted labour can be obtained, with considerable post-partum respiratory difficulties, the child being described as ‘blue in the face’ for some hours after birth. The stress and strain which the advancing head undergoes, and the consequent moulding and overlapping of the various segments of the skull, exposes the brain to great alterations of pressure, and throws considerable tension on the intracranial veins. It is, in fact, rather surprising that birth-hæmorrhages are not more common. The hæmorrhages may be wholly within the meshes of the pia-arachnoid system, but, in the great majority of cases, the lesion is more serious, and the extravasation comes to lie within the subdural space. Occasionally the bleeding takes place beneath the tentorium cerebelli, the blood-clot lying in relation to the pons and medulla. Such hæmorrhages are said to be observed only in vertex presentations. The more common supratentorial hæmorrhages--usually resulting from difficult breech presentations--either remain more or less localized to a certain region of the cortex, or become widely diffused over the surface and base of the brain. It is probable that Cushing is correct in his observations with respect to the source of these supratentorial hæmorrhages. He states that the blood is derived from one or more radicles of the superior longitudinal sinus, especially from those veins which, in their upward passage in the sulci of the brain, leave their cerebral beds for a short and comparatively unprotected course, immediately previous to their entry into the lacunæ laterales of the superior longitudinal sinus.