A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Science
A system of practical medicine. By American authors. Vol. 5 : $b Diseases of the nervous system
Medicine -- Practice
(_b_) A lesion involving the caudal part of the thalamus and of the
internal capsule. With such a lesion the motor symptoms consist in
transient paralysis, with usually persistent post-paralytic chorea or
ataxia. The sensory symptoms are more marked, and resemble those
produced by lesion (_a_). It may be determined with some degree of
accuracy whether the lesion be in the thalamus border, or in the
internal capsule near to the nucleus lentiformis by the absence in the
latter case of lateral hemianopsia.
The topography of such lesions is illustrated by Fig. 7.
[Illustration: FIG. 7. Horizontal Section through the Centre of the
Right Cerebral Hemisphere: M, median line; _Nc_, nucleus caudatus;
_Nucleus lent._, nucleus lentiformis with its three segments; _To_,
thalamus opticus; _c. i._, internal capsule with its frontal division,
its bend or knee, and its caudal division. 1, mass of fibres destined
for pons and others forming a part of the corona radiata,
non-pyramidal fibres; 2, knee of the internal capsule, containing
fasciculus from cortical centre for the face to the nucleus of facial
nerve (non-pyramidal fibres); 3, fasciculus for the tongue and throat
to nucleus of hypoglossus, etc. (non-pyramidal fibres); 4, fasciculi
from the pre- and postcentral gyri and the paracentral lobule to the
pyramid of the oblongata (the true pyramidal fasciculus, continued in
the cord as fasciculi, 10 and 11 of Figs. 5 and 6); 5, the caudal
third of the internal capsule, containing fasciculi destined to the
sensory cortical centres.]
(_c_) Lesions of cortical areas connected with fasciculi of the
sensory part of the internal capsule (c. i. 5).
(_α_) Lesion of the cortical area or centre for smell cannot at
present be diagnosticated. From the results of experiments upon higher
mammals we would expect such a centre to be in the cortex of the mesal
gyri of the temporal lobe.
(_β_) Lesions of the cortical centre for taste are equally unknown; it
is probably situated in the meso-basal aspect of the temporal lobe.
(_γ_) Lesions of the acoustic centre are somewhat better known, at
least as far as the function of hearing language-sounds (psychic
hearing) is concerned. A number of recently-published cases[9] have
quite positively {83} shown that the existence of word-deafness
indicates a destructive lesion of the dorsal gyri (more particularly
the first and second) of the temporal lobe (the left always?). The
lesion may also be in the inferior parietal lobule and gyrus
supramarginalis, penetrating deeply enough to injure the acoustic
fasciculus on its way from the internal capsule to the centre.
[Footnote 9: R. W. Amidon, “On the Pathological Anatomy of Sensory
Aphasia,” _New York Medical Journal_, xl. 113, 181.]
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