The field and limitation of the operative surgery of the human brain / by John B. Roberts.

  • Roberts, John B. (John Bingham), 1852-1924.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The field and limitation of the operative surgery of the human brain / by John B. Roberts. 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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    published,1 has called my attention to the fact that in several of them removal of the tumor would have been readily possible. I give from his paper mentioned an abstract of two cases:— Case IY.—Clinical history: Female, aet. 30. No history of causa- tion. Headache continuous, sometimes agonizing. Percussion of head caused most pain in right parietal region. Vomiting when headache was most severe. Vertigo. Mind clear, but acted slowly ; emotional. Spasms, beginning with twitching of fingers of left hand; most severe on left side, and especially in left arm. Upper as well as lower fibres of left facial nerve partially paralyzed; nearly complete paralysis of left arm ; slight paralysis of left leg. Bowels and bladder partially paralyzed. Impaired sensibility of limbs of left side. Left patellar reflex diminished. Sight very imperfect. Choked disks. Hearing defective in right ear. Pathological anatomy: Carcinoma, about one-and-a-half inch in diameter beneath and adherent to the pia mater of the convexity of the right hemisphere; the pia and dura mater were united by strong adhesions. The tumor involved the middle portion of the ascend- ing parietal convolution and the upper part of the inferior parietal lobule, pushing aside the inter-parietal fissure. The anterior ex- tremity of the tumor was about one-fifth of an inch back of the centre of the fissure of Rolando. On the inner side of the tumor the white matter of the brain was broken down. Case V.—Clinical history : Female, aet. 38. History of syphilis. Blows on the head. Headache with agonizing paroxysms. Top and right side of head sensitive to percussion; and headaches severest in these regions. Vomiting. Vertigo. Great mental irri- tability. Severe left-sided spasm, beginning with twitching in left toes and foot. Partial paralysis of right leg and arm, most marked in leg. Hyperaesthesia. Impaired sight. Choked disk. Head temperature taken once; right parietal region, 97.2° F.; left parie- tal region, 96° F. Pathological anatomy: Gumma. Attached to the fused mem- branes of the right convexity. Involved the upper one-fourth of ascending frontal, and a smaller segment of the ascending parietal convolution, crossing the fissure of Rolando at its upper extremity. 1 Archives of Medicine, Aug. 18S2.