Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case historiesSouthard, Elmer Ernest
Science
Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories
Southard, Elmer Ernest
Neurosyphilis
2. Superficial (subpial) condensation of tissues with sclerosis
(gliosis). The tissues in all areas examined _on the left side_
yielded this effect.
]
HEAD: HAIR in good quantity. SCALP normal. CALVARIUM shows diploë.
DURA MATER over left cerebral hemisphere inseparably adherent to
calvarium, over right hemisphere normal. Arachnoidal VILLI
moderately developed. PIA MATER shows injected veins, notably in the
sulci of the right hemisphere. Pia mater everywhere thin and clear.
VESSELS at base of normal appearance.
BRAIN weight 1180 grams. Spread on a board, the right hemisphere
tends to flatten so that it measures 1.5 cm. more from side to side
than its fellow. Besides more marked venous injection, the right
hemisphere shows also flatter and slightly more plastic
convolutions. The posterior poles of the hemispheres are a little
firmer than the parts anterior. The orbital and hippocampal gyri on
the right side are a little firmer than the surrounding parts. On
section the gray and white matter shows no lesions, excepting the
slight plasticity of the tissues at large on the right side and a
well marked induration, with retraction under the knife, of the
occipital and hippocampal white matter. The basal ganglia of the
left side are normal. On the right side a sagittal section
demonstrates a rounded area of induration, with ill-defined borders,
measuring perhaps 1.5 cm. from above downwards by 2 × 2 cm.,
situated largely in the lenticular nucleus and involving the greater
portion of the globus pallidus, a small segment of the putamen below
and behind and the regionary part of the anterior commissure with
surrounding tissues. The most striking feature of this lesion is the
occurrence in the middle of a cluster of vacuoles or cystic clefts,
with smooth pale interiors, ranging from pinhead to 0.25 cm. or even
0.5 cm. in greatest diameters. There are six to eight clefts to a
surface of section. The color of the lesion differs little from that
of the globus pallidus itself, but the tissue is a trifle
translucent. It is impossible to demarcate the lesion with the eye.
Induration is demonstrable several mm. beyond the visible part of
the lesion. The consistence of the lesion slightly surpasses the
usual consistence of the olivary bodies.
CEREBELLUM, PONS and BULB weight 165 grams. Cerebellar tissue a
trifle more plastic than usual. The right olive is not so prominent
as usual.
=Note.= THYROID: Weight 125 grams. Both lobes and isthmus enlarged.
One lobe more than the other; lobe on one side measuring 6 × 4 cm.
Anatomical Diagnoses
Enlargement of thyroid gland.
Exophthalmos with dilated pupils.
Fatty degeneration of thoracic muscles.
Slight aortic sclerosis.
Dilatation of right heart.
Hypertrophy of left ventricle.
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