Endothelioma of the Gasserian ganglion : two successive resections of the ganglion, first, by the extradural (Hartley-Krause) operation, and secondly, by an intradural operation / clinical report by F.X. Dercum ; surgical report by W.W. Keen ; pathologic report by W.G. Spiller.

  • Dercum, Francis X. (Francis Xavier), 1856-1931.
Date:
[1900]
Catalogue details

Licence: In copyright

Credit: Endothelioma of the Gasserian ganglion : two successive resections of the ganglion, first, by the extradural (Hartley-Krause) operation, and secondly, by an intradural operation / clinical report by F.X. Dercum ; surgical report by W.W. Keen ; pathologic report by W.G. Spiller. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Two other cases have been reported in which the Gasserian ganglion, though not directly involved, suf- fered from the pressure of a tumor. In one of these, reported by Krause,4 there was a large cholesteatoma which filled the third ventricle and also involved the ad- jacent parts, such as the chiasm and sella turcica. The tumor was found to be entirely within the dural sac and there was no involvement of the Gasserian ganglion whatever. The patient had suffered for sixteen years from a persistent and most terrible trigeminal neiiralgia. There had never been present headache, giddiness, vom- iting, irregularity of the pulse nor any other cerebral symptoms. An examination of the eyes by one of the most distinguished ophthalmologists had also failed to reveal any abnormalities. As he regarded the symptoms sufficient to establish the intracranial seat of the affec- tion, Krause decided to remove the Gasserian ganglion, although peripheral nerve operations had not yet been attempted. The removal was followed by complete re- lief of pain. However, about two weeks after the oper- tion. headache made its appearance and cerebrospinal fluid began to trickle from the point of drainage. Not- withstanding the insertion of a drainage-tube and other surgical measures, fever set in and the patient died about four weeks after the operation. It is remarkable that in Krause’s case nothing could be discovered of the tumor at the time of the operation, but this is no doubt to be explained by the fact of the complete intradural situa- tion of the growth. Krause explains the neuralgia from which the patient suffered by compression of the Gasser- ian ganglion and its roots. He also considered it prob- able that the tumor began at the upper edge of the petrous bone; this bone itself was entirely normal. Another case was reported by Homen,8 in which a tumor, an endothelioma of the dura mater, had pressed upon and flattened the Gasserian ganglion and its branches. In this case there had been present toothache in the left upper jaw, intense pain and sensations of cold in the entire left half of the face and complete an- esthesia, the latter also involving the forehead, the an- terior part of the parietal and the temporal regions. The conjunctiva was entirely without sensation, much in- jection, somewhat swollen and the reflexes were absent. The cornea was cloudy, with ulceration on its inner edge.