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
=Head:= Scalp closely adherent to =calvarium=. Calvarium heavy
without diploë. =Dura= adherent to calvarium in bregmatic region.
Sinuses contain liquid blood. Arachnoidal villi in considerable
quantity. =Pia mater= contains considerable clear fluid and shows
diffuse haziness and focal thickenings. The diffuse haziness is
almost universal and is best marked over the superior surface of the
cerebellum. The focal thickenings are of general distribution over
the veins of the sulci on the superior surface of the brim and are
heaped up to form considerable linear mounds near the region of the
arachnoidal villi. The superior surface of the cerebellum is
traversed by similar linear mounds of fibrous tissue running at an
angle to the laminæ. There is no notable increase of fibrous tissue
at the base.
=Brain:= Weight 965 grams. The sulcation is roughly symmetrical
except in the occipital poles where there is unusually rich and
complex but shallow sulcation. The cortical substance is everywhere
firmer than normal, but the sulci fail to flare notably. In a few
places there is a focal increase of consistence of still greater
degree with apparent local hypertrophy (or gliosis with increase of
substance). These foci are in the right second temporal gyrus (3 cm.
in diameter) and in the left first temporal gyrus (of same size but
somewhat less firm) and are of a whitish, waxen appearance, being
visible several feet away by reason of their color and apparent
encroachment upon the adjacent sulci. The foci are sharply limited
by the sulci laterally, but pale out gradually before and behind.
The convolutions of the vertex show another type of lesion. The
tissue of the greater part of the vertex resembles that of the
flanks and base in being firmer than normal and of a grayish pink
color. Behind the fissure of Rolando on the right side and behind
the anterior limits of the ascending frontal region on the left side
the brain tissue of the vertex becomes suddenly still firmer and of
a yellowish gray color. This lesion disappears gradually into the
occipital microgyria behind and the gyri gradually lose their
yellowish tint. The lesion fades away gradually so that it fails to
involve the temporal convolutions.
The cerebral tissue cuts firmly and smoothly. The tissue of the
frontal region is a little edematous. The white matter is of a
normal appearance. The ependyma of all the ventricles is somewhat
sanded. The fourth ventricle is most affected.
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