Case of large cerebral tumour without optic neuritis, and with left hemiplegia and imperception / by J. Hughlings Jackson.

  • Jackson, J. Hughlings (John Hughlings), 1835-1911.
Date:
[1875?]
Catalogue details

Licence: Public Domain Mark

Credit: Case of large cerebral tumour without optic neuritis, and with left hemiplegia and imperception / by J. Hughlings Jackson. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    which had not produced neuritis. As the actual progress of the case showed, the statement, which had not yet produced neuritis, would have been better, for, as I have said, it did come on late. In about six weeks after the onset of the neuritis the discs were again normal. Had I examined for the first time the discs only shortly before death, which occurred in December, 1874, I might have supposed too that the tumour had not produced optic neuritis. It is a very- common thing for the changes of severe optic neuritis to pass off, so far at least as to leave only slight changes recognisable by careful direct examination, and such slight changes which ihould not (without of course knowing that there had bc.cn optic neuritis) dare to caU'relics of neuritis. Let me now mention a still more striking case of late onset of neuritis. The man had had symptoms of brain* disease (convulsions) for about nine years before his death. As from first to last his motor symptoms were all local, the probability is that the patient had had cerebral tumour nine years ; he was under my care three years. He died March 29, 1875, and yet it was only about the middle of February of that year that the neuritis was discovered. His discs had been previously examined scores of times. It may, however, be well to give direct evidence as to the state of his eyes so late in his case as December, 1874. At this time he had some difficulty in reading. I could not determine whether this was part of his aphasia (for his articulation was-at that time ataxic), or owing to defect of sight; his optic discs were normal. Mr. Couper was so good as to examine the patient for me. He too considered the discs normal, but he discovered (by the ophthalmoscope) a high degree of hypermetropia. When, on Mr. Couper's suggestion, we used a f convex, the patient read very much better, but there was a residuum of aphasic difficulty. When the optic neuritis came on, no difference * Case recorded in Medical Times and Gazette, 4th Sept., 1875— Con- tuitions mostly beginning in the right leg; several years later right hemiplegia and aphasia; late onset of double optio neuritis; autopsy; tumour of the left cerebral hemisphere. (The examination of the brain in this case also was made for me by Dr. Gowcrs.)