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In a discussion of injuries of the brain at birth three factors must be considered: the site of the lesion, its nature and its causes. Site of Injury.\p=m-\One must consider the site first, for, except for direct lacerations, all these injuries to the brain are localized in certain drainage areas of the venous system. Veins are more easily damaged than arteries, which are well protected where they enter the base of the skull. The base is already stabilized at birth, while the vault is still movable and easily injured.The venous system in question includes various, somewhat independent, vessels. The regions involved in birth trauma are the drainage area of the great vein of Galen (vena cerebri magna) and that of the superior longitudinal sinus. The former vessel drains the blood from the centrum semiovale of the frontal and the anterior part of the parietal lobe via the anterior terminal vein, and from the posterior part of the parietal and the occipital lobe via the lateral ventricular vein. Even basal parts of the brain, the hippocampal region for instance, are drained by the great central vein (vena cerebri magna) via its basal branch (vena basalis of Rosenthal). Into the superior longitudinal sinus enter the cortical veins, which drain only the gray layer of the cortex and that part of the white sub¬ stance which lies directly below the gray matter and consists of the U fibers and very small ad¬ jacent portions of the centrum semiovale.One must take into consideration another fac¬ tor concerning the entrance of the superficial veins into the sinuses, a factor which was par¬ ticularly stressed by Cushing ' as a source of hemorrhage in the newborn.

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