The Surgery of the Skull and BrainRawling, Louis Bathe
Science
The Surgery of the Skull and Brain
Rawling, Louis Bathe
Brain -- Surgery; Skull -- Surgery
_Incontinence of urine_ has been observed, independent of the condition
of the patient--in other words, without a sufficient degree of coma to
account for the state.
When the tumour is of considerable size, some degree of _paresis_ of the
contralateral side of the body may result, due to backward pressure
exercised by the tumour on the corona radiata preceding from the
pre-Rolandic motor area. Associated with this paresis the deep
_reflexes_ may be increased with extensor plantar reflex (Babinski) and
some diminution of superficial reflexes. The more posterior the tumour
the greater the degree of paresis, and the more exaggerated the
reflexes. When the tumour is situated on the left side the _motor
speech_ centre may be affected.
_Fine tremors_ may be noticed, usually involving the muscles of the
upper extremities, and best demonstrated by asking the patient to hold
his arms horizontally with the palms downwards.
Paresis on the contralateral side may be preceded by or associated with
_fits_, these partaking of the Jacksonian type and accompanied by
conjugate deviation of the eyes towards the side opposite to that on
which the tumour is situated. This association of fits suggests that the
tumour occupies the second frontal convolution.
(_B_) =To the excito-motor frontal region.= In the early stages symptoms
of irritation predominate, the patient suffering from _fits_ of a focal
or Jacksonian type (see p. 189), whilst, later on, _paresis_ of a
progressive type, involving the face or extremities unequally, becomes
evident. In children, however, the rapid transference of impulses from
one motor area to another causes the fits to soon lose their focal
character, _general convulsions_ taking their place.
If the tumour occupies the left side of the brain (in right-handed
individuals) the _motor speech_ centre of Broca may be involved, with
difficulty in or failure of the power of speech.
_Apraxia_ may be present, a condition characterized by inability on the
part of the patient to perform certain familiar purposive movements,
such as sewing, turning a key in the lock, &c.
The contralateral _pupil_ may be contracted from irritation, or dilated
from paralysis; the ipsolateral is variable, more commonly dilated.
In the event of extensive tumour formation and when the growth is
associated with tract degeneration, the deep _reflexes_ will be
increased on the contralateral side, with well-marked extensor plantar
response.
Public-domain text, read in full here on John Shaqi.
Reviews
Reviews
No reviews yet
Be the first to share your thoughts on this work.
Elsewhere in the archive
Join the Discussion
Join the discussion
Sign in to leave a comment or review.
Sign InorCreate an account