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Picture of the Month

Sidney S. Gellis, MD; Murray Feingold, MD; Mark C. Steinhoff, MD
Am J Dis Child. 1977;131(6):709-710. doi:10.1001/archpedi.1977.02120190103024.
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Denouement and Discussion 

Tache Cérébrale 

Manifestations  Tache cérébrale (French, cerebral spot) was first described in 1861 by Trousseau,1 who believed it was invariably present in meningitis, especially the tuberculous form. The sign is elicited by firmly stimulating or stroking the skin with a tongue blade, fingernail, or similar object. There may be a brief period of blanching, followed within 15 to 30 seconds by the appearance of a line of erythema that spreads laterally beyond the original area of stimulus. The width of the red line is related to the pressure of the stroke. The red line may be flanked by areas of pallor, and may last as long as 15 minutes.This finding is apparently an exaggeration of the normal vasodilator reaction of the skin to a mechanical stimulus, and has been described in febrile illnesses other than meningitis. The sign may also be present in patients with cerebral


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