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
=Cord=: Throughout the cervical and dorsal region the dura is quite
tensely distended with an abundance of clear, light, straw-colored
fluid. Upon snipping the dura this fluid escapes with a small spurt,
as if under considerable pressure. The cord within, for the most
part, lies free, but over the upper three or four centimeters of the
cervical portion it is densely adherent to the dura anteriorly and
laterally on the right side. Cross sections were made through the
upper three or four centimeters of the cord, and over this area the
cord is constricted by very marked thickening of all the meninges.
The meninges here average from one to three millimeters in
thickness. On the right side and somewhat anteriorly opposite the
junction of the atlas and axis there is a single nodular, firm mass
which on section shows a yellowish, firm center surrounded by very
dense, pearl-gray tissue. The demarcation between the homogeneous
yellowish centre and its surrounding gray tissue is very sharp. This
nodule measures about 0.75 to 1 cm. in diameter. The adjacent cord
is deeply indented by it. Below this nodule there is a translucent,
grayish appearance of both posterior sensory columns which extends
downwards and diminishes in intensity until it finally disappears in
the upper dorsal region. This same appearance is well marked on the
right outer margin of the upper cervical cord corresponding to the
crossed pyramidal tract, and extends downwards diminishing in
intensity until it disappears about the mid-dorsal region. The left
pyramidal tract appears to be similarly but very slightly involved;
section of the lower dorsal cord entirely negative.
=Microscopically=, characteristic GUMMA.
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