On oxycephaly / by H. Morley Fletcher.
- Fletcher, Herbert Morley, 1864-1950.
- Date:
- 1911
Licence: In copyright
Credit: On oxycephaly / by H. Morley Fletcher. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![By H. MORLEY FLETCHER With Plates 30-38 The cranial deformity now generally known as oxycephaly is also described under various appellations, such as acrocephaly, ‘ Thurmschadel,’ ‘ Spitzkopf,’ tower or steeple-head, ‘ turritum caput,’ ‘ tete a la Thersite ’ (Hamy). The con- dition does not appear to have attracted attention, except as a curious malforma- tion, until the visual defects so frequently associated with it led to investigations on the part of ophthalmologists. Thus we find that all the earlier accounts of this condition, and there are many of them, appear in the various ophthalmo- logical journals of Europe and this country. The almost invariable impairment of vision with its frequent accompani- ment, optic atrophy, was first definitely recognized and described by v. Graefe in 1866, Michel in 1873, and v. Hirschberg in 1883, and since then a large number of cases of this type, as well as of other cranial deformities associated with optic atrophy, have been recorded, notably by v. Hirschberg, Enslin, and Patry. The bibliography shows that many cases have been recorded; the number cannot be accurately given as some are doubtful and others are re-quoted, but it is probably between eighty or ninety. The condition is not very rare and it is very striking, yet it is surpi-ising that in this country it appears to have met with little recognition by clinicians until quite recently. My own attention was directed to the condition by a case I met with about eight years ago, at the East London Hospital for Children, in conjunction with my colleague the late Mr. Hancock, and since that time I have been endeavouring to investigate the subject further, as it presents points of very considerable interest. Clinical Aspects. The cardinal signs are the characteristically shaped skull, exophthalmos and impairment of vision, sometimes amounting to total blindness, associated with changes in the fundi oculorum. The aspect of the patient is very striking, the great height of the forehead sloping gradually upwards to the vertex with feebly marked superciliary ridges. The vertex of the skull appears pointed instead of flattened or rounded, and a ridge, or bony prominence, is sometimes felt in the region of the bregma. The hairy scalp may be raised above the normal level and present the appearance of IQ. J. M., April, 1911.]](https://iiif.wellcomecollection.org/image/b22463859_0005.jp2/full/800%2C/0/default.jpg)
