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
The vessels at the base are normal. There is no evidence of pial
thickening at the base of the brain. =Brain= weight, 1265 grams. There
is visible atrophy of both superior frontal gyri and of the upper
two-thirds of both central gyri. The extent of palpable sclerosis
surpasses that of visible atrophy. Palpable increase of consistence is
shown by the prefrontal, orbital (more marked on left side), frontal,
central, hippocampal and occipital regions. The temporal cortex is of
normal or slightly reduced consistence.
Section of the cerebral cortex shows everywhere preservation of the
cortical markings. The sclerosed areas show a diminution in depth of the
cortex, which is more marked in the left prefrontal region. The white
matter of the centrum semiovale of the prefrontal and occipital regions
on both sides shows an increase of consistence. The cerebellar cortex
also shows variations in consistence. The clivus and lobus cacuminis and
the posterior half of the inferior surfaces of both cerebellar
hemispheres are firmer than normal. The laminæ of the left clivus are a
trifle narrower than those of the right. There is visible extensive
atrophy of the laminæ on both sides of a fissure in the middle of the
left lobus cacuminis. In the coördinate portion of the right cacumen
there is a similar process which is less marked. The dentate nuclei are
firm. The olives show an increase of consistence, equal on both sides.
The left olive shows on section a crowding together of its folds in the
middle part of the upper limb.
Spinal cord was not remarkable.
=Summary=:
Adhesive pachymeningitis
Chronic fibrous leptomeningitis
Miliary pial macules
Cerebral atrophy
Cerebral sclerosis
Cerebellar atrophy and sclerosis
Bronchopneumonia
Chronic splenitis
Nephritis
Aortitis
=It is generally recognized that DIFFUSE NEUROSYPHILIS
(“cerebrospinal syphilis”) frequently is cured through
antisyphilitic therapy. Example. Mental improvement, in one month;
recovery from paralysis, ten months.=
=Case 104.= John Edwards, a man of 28 years, well developed and
nourished, with general enlargement of glands and skin lesions, came to
the hospital in a stuporous condition, with evidences of a complete
hemiplegia.
According to the wife, Edwards had had a chancre of the lip about a year
before, for which he had been treated with an intravenous injection,
presumably of salvarsan, and also presumably with mercury. The lip
lesion had then disappeared. For a month before admission, Edwards had
had headache and dizziness, for which he was given pills and drugs.
There had also been difficulty with speech and numbness of the left arm
as far up as the elbow, but this paresthesia had quickly disappeared.
The hemiplegia was of only a few days’ duration. After a feeling of
nausea and vomiting, the patient had fallen with left-sided paralysis.
Afterwards, he had shown mental peculiarities, eventually becoming
noisy, hard to manage, and appropriate for hospital care.
Public-domain text, read in full here on John Shaqi.
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