File:Organic and functional nervous diseases; a text-book of neurology (1913) (14781873895).jpg

Identifier: organicfunctiona00star (find matches)
Title: Organic and functional nervous diseases; a text-book of neurology
Year: 1913 (1910s)
Authors: Starr, M. Allen (Moses Allen), 1854-1932
Subjects: Nervous system Nervous System Diseases
Publisher: New York, Philadelphia, Lea & Febiger
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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s and in the meninges of the brain and spinal cord are verycommon as a sequel of syphilitic disease, especially as an early mani-festation, cases having been observed within six months of the initiallesion. They may occur as a diffuse glue-like mass over a large areaof the surface or base of the brain or cord as shown in Figs. 290 and291, or they may be more distinctly encapsulated, forming a definitegummy tumor, and such gummy tumors are often multiple. The glue-44 690 SYPHILIS OF THE NEBVOUS SYSTEM. like substance is deposited rapidly and extensively through the meningesand produces pressure upon the subjacent brain, or cranial nerves,or spinal cord and nerves, and upon the bloodvessels. It thereforecauses a suspension of function both of the tissues compressed directlyand of regions at a distance when their blood supply is cut off. The usual history of a case of brain syphilis is as follows : After aperiod of several weeks of indefinite nervousness with inability to work, Fig. 290.
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Multiple gummata upon the base of the brain and about the cerebellum. (Siemerling ) discomfort and restlessness in the late afternoon, with dull headacheworse at night, and sleeplessness, the patient is suddenly seized withvery intense headache, is dizzy and sees double. He may have numb-ness in one side of the body and a feeling of incapacity for all thoughtor eflPort. On examination a third nerve palsy may be discovered, ora beginning optic neuritis and possibly a slight hemiplegia or hemi-ansesthesia. An epileptiform attack occasionally precedes the onset or PATHOLOGY. 691 may occur after other symptoms have appeared. The condition ifpromptly treated soon begins to improve, the ptosis and strabismussubside, and in four or six weeks the patient has no objective signs ofthe attack and is free from symptoms. If it is not treated the symptomsof brain tumor upon the base ensue. This is the usual history of anexudation of gummy nature upon the base of the brain about the crura,its point

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