To the Editor: The recent article on hydranencephaly by Dr. Kaloss and Dr. Kuhnlein (Amer. J. Dis. Child. 103:177) is a provocative one and restimulates a point of contention regarding the pathogenesis of this very interesting pediatric neurologic problem.
These authors imply that there is almost complete absence of the cerebral cortex "... in this condition, both cerebral hemispheres, apart from imperfectly developed basal gyri, are replaced by a liquor-filled, double bladder, the wall of which consists of the intact meninges. The skull is normal. The midbrain is imperfectly formed, while the lower structures (pons, medulla, and cerebellum) are normal." This seems to run contrary to the neuropathological findings as described by Greenfield (Hydranencephaly, in Neuropathology, London, Edward Arnold Publishers, Ltd., 1958, pp. 328-329). "The affected areas are mainly those supplied by the internal carotid arteries, while those receiving blood from the vertebral system tend to be spared. The latter include