A Study of Fiber Tract Degeneration in a Case of an Acoustic Neuroma *

The ability of the brain to maintain a considerable degree of normal function in the presence of tumor, and in spite of distortion and hydrocephaly, has always been a matter of interest. Such a condition is best seen with slowly growing masses, such as the acoustic neuromas. Recently, such a pathological condition has been encountered in a patient in the New Haven Hospital. After viewing the large tumor at the post-mortem examination and noting the extreme distortion of parts of the brain and the damage to the cranial nerves, considerable surprise was expressed at the apparent lack of correlation between the anatomical damage and the physiological impairment shown before death. It was felt, therefore, that a study of the fiber tracts of portions of the brain might yield some information, both as to the actual amount of degeneration and the localization of this damage. From the anatomical findings it was hoped that a correlation with the symptomatology might be made. In reviewing the literature, it has been impossible to find a complete anatomical study. It is proposed, therefore, to give (1) the clinical history and pathological findings, and (2) the anatomical findings with a discussion of their relation to the symptomatology.