Two cases of tumour of the brain contrasted / by T. S. Clouston, M.D.

  • Thomas Clouston
Date:
[1875]
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of tumour of the brain contrasted / by T. S. Clouston, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    excitement, the curious thing being that sometimes one side of the body was affected, and sometimes the other. She got steadily- weaker in muscular power, fell off in flesh, and became more forgetful and demented, though when roused by questions she would answer coherently, until, in three months from the tnne she liad the first attack of hemiplegia, she was almost constantly con- fined to bed. Slie lingered on, however, for another year, being up to within three months of her death subject to the attacks of excite- ment, which latterly consisted simply in her being restless and apt to come out of bed for about a day at a time. When the hemiplegic attacks came on she could not speak, her tongue and labial, as well as her facial, muscles being paralyzed on one side. Towards her death both sides of the body were permanently paralyzed, but the left more so than the right. There was never any tendency to permanent contraction of the muscles in any part of the body. She was wet and dirty in her habits, but never had any tendency to bed-sores. She never lost her sight, and she spoke slowly, like an old person. She lingered at the end for months after she was expected to die, not being able to articulate at all for the last six weeks of her life. She always ate well, digested well, and was regular in her bowels, up to near her end. She died of sheer exhaustion, without any convulsion, on the 5th April 1875, three years after her first mental attack, and eighteen months after the first attack of hemiplegia. Post-mortem Examination.—The body was very much attenuated indeed. Head.— Skull-cap slightly unsymmetrical, right side bulging. The dura mater had an opening in it about three- quarters of an inch in diameter, in the middle of the frontal region, through which part of a tumour projected. On removing this membrane, this tumour was found slightly attached to it, and embedded in the brain between the two hemispheres, but project- ing much more into the left than the right anterior lobe. This tumour was scarcely adherent to the brain at all, but had pushed the cerebral structure out of its way; and the convolutions in contact witli it were not apparently softened, and not much atrophied. It was almost globular in shape, about an inch and a half in diameter, and in consistence fleshy rather than fibrous. On section it was found to be of a grayish-white colour, easily lacerable, and sliowed a slight tendency to break down in the centre. Near the tumour the dura mater, pia mater, and arachnoid were slightly matted together, but they did not adhere to the brain. The tumour seemed to have originated in the pia mater; the dura mater was very much thickened, and had three thin bony plates on its inner surface, along the junction of the falx, but to the left side just behind the vertex. The largest was three-quarters of an inch in circumference. The arteries everywhere were excessively atheromatous, their calibre enlarged and patent, those at the base very tortuous.