On the clinical significance of double optic neuritis in children and young adults, and on the capacity for recovery from symptoms of tumour of the brain / by C.O. Hawthorne, M.D.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949
Date:
[1899]
Catalogue details

Licence: Public Domain Mark

Credit: On the clinical significance of double optic neuritis in children and young adults, and on the capacity for recovery from symptoms of tumour of the brain / by C.O. Hawthorne, 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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    a localized lesion in the brain, such as paralysis of a limb or a hemiplegic attack. Possibly, though certainly very rarely, such paralyses may occur in meningitis, but the presumption from such incidents is decidedly in favour of tumour. Again, it is to be remembered that in several of the patients the evidence of active intracranial disease extended over many weeks, and even months—a state of matters difficult to recon cile with a diagnosis of meningitis. And if the cases were cases of tubercular, and presumably therefore of basal, meningitis, the absence of disturbance of the functions of the ocular muscles is certainly remarkable. Further, in the one patient seen throughout the whole course of her very serious illness the temperature, so far as it was disturbed, had a range below the normal level, and two other members of the series seen with more or less acute symptoms were also free from evidence of fever. The degree of the optic neuritis is also of importance in the discussion of this question. Optic neuritis is un- doubtedly present in a certain number of cases of meningitis, but it is almost invariably of slight, or, at the outside, of moderate development. But in all the present seven cases— with the possible exception of the last—the degree of optic neuritis either was, or had been, of the considerable or extreme degree usually found with, and indeed strongly suggestive of, intracranial tumour. The balance of probability, even when attention is confined to the facts of the present cases, thus strongly inclines to the diagnosis of tumour rather than to that of meningitis. Other considerations support this view. Thus it is a fact that a tumour, or even tumours, may develop in the brain and yet fail to give the slightest clinical evidence of their existence. Such growths, too, may be of considerable size, and may occupy parts of the brain which, to judge from general experience, are by no means tolerant of disturbance. The cerebellum, the frontal lobe, the occipital lobe, the temporo-sphenoidal lobe, even the motor tract, has each in turn been found to be the seat of a tumour which during life gave no evidence of its presence.1 A step in advance of these cases is provided by a further series in which, with a tumour JSee Table I., p. 126. H
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