Tumor of the superior parietal convolution, accurately localized and removed by operation / by Charles K. Mills and W.W. Keen ; with a pathological report on the nature of the growth, by W.G. Spiller.

  • Mills, Charles K. (Charles Karsner), 1845-1931.
Date:
[1900]
Catalogue details

Licence: In copyright

Credit: Tumor of the superior parietal convolution, accurately localized and removed by operation / by Charles K. Mills and W.W. Keen ; with a pathological report on the nature of the growth, 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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    showed that he had distinct but not very marked ataxia both in the right upper and lower extremities, the ataxia being more marked in the arm. Sensation to pain, touch and temperature was impaired over the right half of the body, and he had dis- tinct astereognosis in the right hand. Muscular power was good in the right arm and leg, although the patient complained of a feeling of heaviness in these parts. Between August 21 and September 25 I saw the patient three or four times. The ataxia of the extremities got gradu- ally worse, and he daily complained of a sensation of pressure or pain, which he always referred to the left parieto-frontal region. On questioning him closely about the sensation he would usually state that it was not exactly pain but rather a feeling of pressure or distress, although at times he referred to it as a pain or even as a headache. From September 25 I saw the patient almost daily, and not infrequently twice or oftener in a day. About this time I first expressed the opinion that he was probably suffering from a slowly developing brain tumor. Frequent examinations were made after he came under constant observation, the results being similar to those ob- tained September 29, when he was seen in consultation with me by Dr. F. X. Dercum and Dr. Wm. G. Spiller. The follow- ing points were recorded at this time: Hypesthesia to touch, pain and temperature was present on the right side of the body; face, trunk, arm and leg all being examined. Sensation wras nowhere completely lost, although distinctly impaired as determined by numerous tests. Sensa- tion was a little less impaired in the right side of the nose and in the right cheek near the nose than in other regions in this half of the body. The mucous membranes on the right, as well as the skin, showed partial anesthesia. The right conjunctival reflex was diminished. Examination for hearing, smell and taste showed also some slight diminution, a result which was subsequently not uniformly obtained. Frequent tests were made with his right hand as to the condition of the stereog- nostic sense. He was found to have distinct astereognosis in the right hand. Ataxia of both the upper and lower extremity on the right side was very marked, and he was also somewhat paretic in both, but more so in the leg than in the arm. The knee-jerk, quadriceps-jerk, and other tendon and muscle phe- nomena on the right side were slightly exaggerated, and he had distinct but soon disappearing ankle-clonus on the right side; toe-jerk and front-tap were absent. The Babinski reflex at this time was also' absent, irritation of the ball of the foot causing plantar flexion. The patient at the time of the exami-