Neurosyphilis : $b Modern systematic diagnosis and treatment presented in one hundred and thirty-seven case histories — John Shaqi
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
This improvement continued until about two years later, when he again
had a relapse, and was seen medically once more. His condition at this
time was still a pretty good one, but the movements were stiff and
awkward. The bin-iodid of mercury was advised, which was taken in doses
of 9⁄25 grain daily. It will be remembered that this was long before the
days of salvarsan treatment.
This was toward the end of June, 1907. Contrary to expectation, there
was no material gain from this treatment, and the patient died early in
October, without being seen again.
The =autopsy= was limited to the =nervous system= and the findings were
as follows (Dr. A. R. Robertson):
=Head=: Hair abundant, fair, of fine texture and rather curly. Scalp
of medium thickness and strips readily from calvarium. The latter
appears normal and upon removal is of about the normal thickness. It
lifts readily from the dura mater, except for the numerous
attachments of Pacchionian granulations.
=Meninges=: The dura is smooth, moderately injected and shows no
areas of thickening; it lifts readily from the pia-arachnoid. The
pia-arachnoid shows discrete and in many places diffuse areas of
opacity. There is a moderate amount of subpial clear fluid and the
vessels are moderately injected. Over the anterior surface of the
medulla and lower portion of the pons and largely confined to the
right side there is a very marked thickening of the pia-arachnoid to
which the dura is densely adherent. This thickening extends down
anteriorly and laterally on the right side over the upper part of
the cervical cord. The thickened meninges over the upper part of the
medulla completely surround the right vertebral artery, shortly
before it joins its fellow of the opposite side to form the basilar.
Dissection of the arteries shows them to be patent and thin walled.
Over the =cerebrum= and cerebellum the pia-arachnoid strips readily
leaving a smooth surface. Section of the cerebral cortex, basal
nuclei, pons and cerebellum show no gross lesions. The ventricles
are moderately distended with fluid. The ependyma contains numerous
small cysts. Section of the =pons= shows no lesions of the nervous
tissue, but very marked thickening of the surrounding meninges as
noted above.
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