Paralysis and other diseases of the nervous system in childhood and early life.

  • Taylor, James.
Date:
1905
Catalogue details

Licence: Public Domain Mark

Credit: Paralysis and other diseases of the nervous system in childhood and early life. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    tumour to be the focus and centre of widely-spread meningitis. Tuberculous meningitis affects the pia-arachnoid and its processes, the small vessels entering the surface of the brain and the superficial tissues of the brain itself. Occasionally a few tubercles are found upon the dura mater. In nearly all cases the convexity of the brain is least affected or escapes, and the only changes seen in that region are flattening of the convolutions, with pressing' to- gether of the latter along the sulci. In the intercrural space, around the optic chiasma, covering the tips of the temporal lobes, along the commencement of the Sylvian fissures, and around the brain-stem, there is inflammatory tissue of a yellow-green colour and of tough consistency. Spreading from the edge of this, in decreasing numbers, grey tubercles are seen in the pia arachnoid, especially in the region of the commencement of the Sylvian fissure. If this yellow tissue be examined by scraping where it is not too dense, or by opening up the Sylvian fissure which it firmly closes, it is seen to consist, for the most part, of grey or white tubercles which have become partly confluent, covered with a fibrino-purulent membrane. So firmly does this substance cling to the brain tissue, that some of the latter comes away in the attempt to remove the affected pia arachnoid. Tuberculous granulations may be found wherever the pia arachnoid extends (the convexity, as a rule, excepted), predominantly in the depth of the Sylvian fissures, over the gyrus fornicatus, between the cerebrum and cerebellum, and upon the velum interpositum. Except at the base, the tubercles are not generally accompanied by the character- istic tough, greenish-yellow tissue. The brain as a whole is soft—sometimes diffluent—even when no hydrocephalus is present. There are several causes for such softening. Spreading in from the pia arach- noid, the tuberculous process attacks the small vessels running vertically into the cortex, and tubercles arise in their walls sometimes in such numbers that a small 2