The cerebral and ocular complications of anaemia and the probable relationship of these to thrombosis : an address delivered to the Medico-Chirurgical Society of Glasgow / by C. O. Hawthorne.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949.
Date:
1909
Catalogue details

Licence: In copyright

Credit: The cerebral and ocular complications of anaemia and the probable relationship of these to thrombosis : an address delivered to the Medico-Chirurgical Society of Glasgow / by C. O. Hawthorne. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

    15/30 (page 11)
    disturbances likely to occur in the tissues in the immediate neighbourhood of the obstructed vessel. These disturbances include such events as hemorrhage, oedema, and softening, any one of which, if favourably situated, may readily interfere with the functions of the centre or trunk of one or other of the cranial nerves. Possibly such considerations, though plainly applying to ocular paralyses occurring in anaemia, may be said to leave untouched the issue in regard to optic neuritis. Yet even here the chance of finding an explanation is not altogether hopeless. A thrombus, particularly if it is formed in one of the larger sinuses, may be regarded as a foreign body or adventitious product within the skull, and in this sense conies under Hughlings Jackson's definition of intra- cranial tumour. So presented it appears as a not improbable cause of optic neuritis, or at least the connection between it and optic neuritis is hardly more mysterious than is the connection between optic neuritis and any other form of tumour. With this suggestion, too, must be taken the fact that sinus thrombosis pure and simple is very much less likely to be accompanied by general symptoms of cerebral disturbance than is thrombosis aftecting the cerebral veins. Indeed, there can be little doubt that a limited sinus thrombosis may occur entirely without clinical evidence of the fact. On the other hand, it is in cases where the cerebral veins are involved—and especially where they are extensively involved—in the throm- botic process, that severe and general symptoms display themselves. Hence there is no difficulty in imagining in a case of anaemia a sinus thrombosis sufficient to cause such a limited clinical expression as optic neuritis and yet failing, in consequence of non-extension of clot formation to the cerebral veins, to excite any general exhibition of cerebral disturbance. Such a _ suggestion, it may be held, provides a possible explanation of optic neuritis appearing as an isolated event in anaemia, and also meets the objection that, were the cause of such neuritis thrombus formation within the skull, there must needs be clinical evidence of this on a more or less extensive scale. In any event, whether the proposals here advanced on the theoretical aspects of optic neuritis and ocular paralyses occurring as clinical facts in cases of anaemia are, or are not, warranted, it is beyond question that intra- cranial thromboses may and do occur in anaemia, and that among the clinical evidences of such thromboses optic neuritis and ocular paralyses are most unquestionably to be numbered. _ Again, it has been urged that if thrombosis of the veins and amuses within the skull can cause optic -neuritis the same