Encephalography in Cases of Increased IntraCranial Pressure*
Encephalography is an invaluable diagnostic procedure which until very recently has been used far too infrequently in the diagnosis of cerebral conditions. By the term encephalography is meant the spinal subarachnoid insufflation of air for the purpose of roentgenographic examination of the brain, as contrasted with ventriculography in which method the air is introduced directly into the lateral ventricles through trephine openings in the skull.
My experience with encephalography in cases of increased intracranial pressure would seem to indicate that the reluctance with which most neurological surgeons in the past resorted to this method was not entirely justified. During the past year in the Cleveland Clinic 24 encephalograms have been made in the cases of 19 patients in whom the spinal fluid pressures varied from 260 to 850 millimeters of water. Very few untoward symptoms have resulted from the procedure; as a matter of fact, it has been found that patients with brain tumor usually do not have as severe an immediate reaction to a spinal insufflation as do patients in whom other cerebral conditions are present.**
Encephalography should be resorted to in the diagnosis of cerebral conditions only after a careful history of the patient has been secured and a painstaking examination has been made. However, our experience would seem to indicate that in a very considerable number of cases in which a craniotomy is indicated an encephalogram should be made prior to operation. Few general surgeons will operate upon a kidney without a pyelogram having been made or. . .