Identifier: diseasesofchildr00grah (find matches)
Title: Diseases of children
Year: 1916 (1910s)
Authors: Graham, Edwin Eldon, b. 1864
Subjects: Children Disease
Publisher: Philadelphia and New York, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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points to the absence ofany prolapsed portion of the spinal cord. Untreated cases sooner orlater develop infection of the skin covering the sac, with subsequentspinal meningitis and death. Ulceration of the skin may take place,with rupture of the sac, the rupture healing, but again breaking open,and finally death from infection results. Paralysis, as it dependsupon the amount of injury done to the cord or the existence of the 102 CONGENITAL MALFORMATIONS cord ill the tumor, is rarely present in spinal meningocele. In a cervicaltumor paralysis is rare, being much more common in the lumt^osacralforms. Paralysis, to a certain extent, depends upon the location ofthe tumor; if low down in the sacral region and only the cauda equinais involved, the bladder and rectum may escape, and the legs be onlypartially paralyzed. A very small spinal opening may occasionallybe closed by inflammatory exudate, resulting in a spontaneous cure;this, however, occurs so rarely that it is not to be expected.
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Fig. 17.—Spina bifida occulta. Trophic changes, as shown by ulceration, are not uncommon.Motion and sensation may be normal or disturbed in the legs, andincontinence of urine or feces may be present. Other deformities ofthe body are not uncommon. A depression marks the centre of themyelocystocele, and the fissure in the entire vertebral column isusually palpable. Diagnosis.—The different forms of spina bifida are difficult todiagnose but the location of the tumor is of some assistance. A menin- ATRESIA OF THE VAGINA, LABIA, AND URETHRA 103 gocele is apt to be traiislucciit hikI pedunculated, and sliows no e\idenceof spinal fissure; it is irnportant to differentiate this form f)n accountof the better results following operation. ^Myelomeningocele is aptto be associated with paralysis, a depression exists in the centre of thetumor, it has a broad base, and on palpation the bony fissure can usuallybe distinctly felt. The tumor is rarely large, and is not apt to bepedunculated. Myeloc

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