A handbook of the theory and practice of medicine / by Frederick T. Roberts.
- Frederick Thomas Roberts
- Date:
- 1883
Licence: Public Domain Mark
Credit: A handbook of the theory and practice of medicine / by Frederick T. Roberts. Source: Wellcome Collection.
912/1006 (page 892)
![on the side opposite to that on which the cranial nerves are implicated. Rarely these disorders are bilateral, or they may be very limited. At the outset signs of irritation are observed, followed by gradually progressive paralysis, which is accompanied with spasmodic movements or rigidity. Electric irritability is not lost in the limbs. When a tumour occupies the interior of one cerebral hemisphere, there may be pure hemiplegia. Epileptiform convulsions are not uncommon, the convulsive movements being frequently localized mainly in some particular part, as has already been described under epilepsy. When a tumour occupies certain portions of the brain, peculiar rotatory and other movements are observed. A special feature in tumours of the cerebellum, more especially of the middle lobe, is said to be a tonic rigidity of the muscles of the back of the neck, with retraction of the head, associated frequently with flexion of the fore-arms and extension of the legs, with pointing of the toes. They also press on the venae Galeni, and cause dropsy of the ventricles, with corresponding mental symptoms. The important ophthalmoscopic signs of cerebral tumour are those of ischaemia; descending neuritis; or atrophy of the disc. Occasionally a tumour becomes evident external])-. In cases of aneurism, it is said that a murmur has been occasionally heard over some part of the skull. The general condition of the patient varies much. The constitution is gravely affected, should there be much suffering, with loss of sleep. Sometimes considerable emaciation and , marasmus, or evidences of some cachexia are observed ; or cancerous, syphilitic, or tubercular deposits may be discovered in other parts. The mode in which cases of cerebral tumour terminate is very variable. In those which have come under my observation the end was always unexpected, acute symptoms setting in without any obvious cause. IV. Chronic Hydrocephalus. Etiology and Pathology.—Chronic hydrocephalus is characterized by accumulation of fluid, either in the ventricles ; in and beneath the arachnoid; or in both these situations. In the great majority of cases the condition is either congenital, or is revealed within six months after birth, and has then been chiefly attributed to arrest of development of the brain, or to chronic inflammation of the ventricular lining membrane. It may come on as an acquired complaint, however, in older children, or very rarely even in adults, being then the result of closure of the venaj Galeni, usually the consequence of pressure by a tumour. Chronic hydrocephalus has no connection with tubercle, but is not uncommon in cases of rickets. Excess of fluid may accumulate in the arachnoid sac in connection with senile or other forms of atrophy of the brain; or after previous haemorrhage. Anatomical Characters.—The quantity of fluid in cases of chronic hydrocephalus varies from a few ounces to several pints. It is usually watery, limpid, and colourless; of low specific gravity; and contains but a very small quantity of albumen, with some saline matter. The ven- tricular lining membrane is often altered in appearance, thickened, granular, and rough. The arachnoid is stretched, and signs of chronic meningitis are often observed about the base. The brain is altered in shape, sometimes unsymmetrical, its convolutions being flattened and spread out; and its texture is in many cases firmer than natural, or, on the other hand, soft and macerated. The optic nerves are usually much](https://iiif.wellcomecollection.org/image/b20399893_0912.jp2/full/800%2C/0/default.jpg)
