Experimental Study of Distant Effects of Acute Focal Brain Injury

Abstract

Immediately following an acute transverse lesion of the spinal cord there ensues a state known as spinal shock.¹Although not always recognized as such, an analogous situation can occur at more rostral levels, appearing, for example, subsequent to a rapidly developing lesion of a cerebral hemisphere. From clinical observations, von Monakow²formulated the concept that a transient depression of function can occur at a distance from a circumscribed lesion of the brain. He applied the term diaschisis to designate this circumstance. It is pointed out by Riese³that von Monakow's ideas have received little emphasis by English-writing neurologists. Riese suggests that this is because von Monakow's best-known publication, "Die Lokalisation im Grosshirn," appeared in Germany in 1914, at about the time of the outbreak of the First World War. He also emphasizes that this work has been little read in the United States, possibly because of the