PORENCEPHALY: DIAGNOSIS AND TREATMENT

Porencephaly is a neurologic entity capable of clinical diagnosis. Since Heschl's 1 publication in 1859, the subject has been viewed largely from the standpoint of the gross and microscopic pathologic characteristics and pathogenesis and has received scant clinical and therapeutic attention. In a search for the causes and means of relief of convulsive states our attention was directed to a group of nine persons in whom the features distinguishing the condition from idiopathic or essential epilepsy were the presence of organic neurologic signs and focal seizures and the absence of evidence of increased intracranial pressure. In all cases there was evidence of a neurologic abnormality existing since early childhood, except in one instance in which a later trauma was the unquestioned etiologic factor. Study of these cases enabled us to make a tentative clinical diagnosis of porencephaly. This was confirmed subsequently by encephalographic studies, and relief was obtained in a