Aug. 10, 1932.

Dr. Cushing

• This woman had a choked disc, bitemporal hemianopsia, and sensory hypaesthesia of her right side. In addition to this she had a peculiar slowness of speech and weakness of the right lower face with suggestive anomia. I had a suspicion that she might very likely have a left temporal tumor though I could not account for the bitemporal hemianopsia on this basis. Ventriculograms seemed in order and these show normal ventricles with what appears to be a filling defect in the third ventricle. I have been given to understand that the left temporal horn is normal. It seemed best, therefore, to have a look at the chiasm at least to see whether anything was present there and if not to leave the usual right-sided large flap decompression so that the ventricles might be allowed to dilate and the lesion attacked by a trans-ventricular incision. The operation was relayed with Dr. Horrax.