The Medical and scientific archives of the Adelaide Hospital. No. 2.

  • Adelaide Hospital (Adelaide, S. Aust.)
Date:
[1923]
Catalogue details

Licence: Public Domain Mark

Credit: The Medical and scientific archives of the Adelaide Hospital. No. 2. Source: Wellcome Collection.

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    could not concentrate his mind in answering questions. He had control of his sphincters. The temperature was 98° F., respira¬ tions 20, and pulse 60. The pupils were equal, and reacted to light and accommodation. There was pseudo-nystagmus through lack of attention. The tongue was protruded in the mid¬ line. The knee jerks were increased on both sides. The plantar reflexes were flexor in type. The wrist jerk and testicular reflex were absent on the right side. There was no superficial abdominal reflex. The patient walked unsteadily with a wide base. There was no definite rhombergism. The abdominal and thoracic organs appeared to be normal. The urine was acid, with specific gravity 1020, no albumin, and no sugar. On April 10th, 10 c.c. of clear fluid under pressure was removed by lumbar puncture. This gave a positive ammon. sulph. reaction and a negative Wassermann reaction; it showed no increase of lymphocytes, and no tubercle bacilli or other organisms. On April 12th there was restlessness, especially at night. The patient micturated and defeecated anywhere. He appeared more childish in his conduct, and had had three attacks of projectile vomiting. On April 27th the patient was quieter and much more rational. By May 10th he had no vomiting, but was gradually losing condition. He could not recognise his friends, and lay in a dreamy state. On striking the muscles there was localised fibrillary contraction. There was no cranial nerve involvement. His habits were dirty. On June 6th he lapsed into coma after having improved in mentality, and died. The examination of the eyes by Dr. Shorney showed the veins very tortuous and cedema of the retina with haemorrhages, but the patient would not allow a proper examination to be made. His temperature was normal throughout, except for an occa¬ sional rise to 99° or 99.6° F. In the Adelaide Hospital his pulse rate was usually about normal, occasionally as low as 60 and sometimes up to 106. Post-mortem examination revealed a gliomatous tumor occupying the mesial aspects of both frontal lobes. Extent of the Neoplasm (Dr. T. Grant).—A mass occupies the anterior part of the mesial aspect of both cerebral hemi¬ spheres. On the left side the mass measures 7 cm. in length; it is broader anteriorly where the greatest measurement is 5 cm., and from this point it tapers to its posterior extremity. In depth the mass extends 1.5 cm. from the mesial aspect of the brain. The posterior extremity is situated above the corpus callosum and just anterior to the centre of this portion of the brain. The anterior extremity is about 1.5 cm. from the frontal pole. The grey matter of the lateral aspect of the brain is not involved. On the right side the mass measures 5 cm. in length; anteriorly it is as broad as 5 cm. The greatest depth from the mesial aspect of the hemisphere is 1.3 cm. The posterior extremity is situated above the corpus callosum about 2.5 cm. posterior to the genu. The anterior extremity is 1.5 cm. from the frontal pole. The grey matter of the lateral aspect of the brain is not involved. Microscopical Appearances (Drs. Cleland and Bull).—The growth is a cellular one, though the number of cells varies much in different parts. Thus we may find a strand of tissue with closely packed cells with nuclei parallel to each other, and beside this a strand almost devoid of nuclei and composed of indefinite fibrils. These cellular strands may perhaps be con¬ sidered as showing the same type of arrangement as is met
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