Cases of intra-cranial tumour / by Byrom Bramwell.

  • Bramwell, Byrom, Sir, 1847-1931.
Date:
[1878-1879]
Catalogue details

Licence: Public Domain Mark

Credit: Cases of intra-cranial tumour / by Byrom Bramwell. Source: Wellcome Collection.

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    Ca^ ly. Male^ mt. 23. Syphilis Seven Years before Admissiori to Hospital. Severe Secondary and Tertiary Symptoms. Headache and hpileptiform Conmdsions Six Years after the Primary Affec¬ tion. State on Admission: Intense Headache, worse at Night I and confined to the Left Side of the Head : Periostitis of the Left I Temporal Bone : Convulsions of Two Kinds ; “ Slight f without Loss of Consciousness, confined to the Muscles of the Bight Side of \ the Face and Tongue; “ General ” preceded by a well-marhed I Aura, and attended by Loss of Consciousness: Bight-sided Post- : epileptic Hemiplegia ; Post-epileptic Aphasia. \* single, a sailor, was admitted on 29tli August I 1875, complaining of intense pain in the left temple and left ear, : ditnculty in speaking, and fits. I Previous History. At the age of sixteen he contracted syphilis. I The attack was a severe one, and he has never been well since. I Fifteen months ago he began to suffer from pain in the left side of j the head. Soon afterwards he began to take fits. Tour months I ago his speech became affected. Tor several weeks past the head- I ache has been intense. Family History.—Unimportant. State on Admission.—He is thin and emaciated. There are numerous white cicatrices, the remains of tertiary ulcerations, on the arms and legs. The left temple is swollen and tender to the touch; the swelling is hard, and extends backwards towards the left ear. Fxpression and Mental Faculties.—The expression is dull and heavy; it may be called epileptic, for so characteristic is it that my triend Dr Herbert Major, in coming into the ward, at once said that is an epileptic.” The patient is intelligent and well educated. His memory is very defective. Sensory Functions.—He complains of great pain all over the left side of the head, and of numbness in the right thumb and righk mde of the face. Sensibility seems otherwise natural. The pain is always worse at night, and is sometimes agonizing. He sleeps badly, and is much disturbed by dreams. Speech is hesitating and difficult. He seems unable to get hold of the word he wants, often stopping in the middle of a sen¬ tence, frequently stammering and repeating the same word over and over again. He can repeat the alphabet after me readily enough, but when he attempts to say it alone he sticks after a few letters, and. says he cannot say the rest. He is, too, unable to write it. Twitchings of the facial muscles are very frequent during his attempts to speak. Special Senses. Sight is considerably impaired in the left eye, less so in the right. The right pupil is irregular and fixed. On ophthalmoscopic examination, marked neuro-retinitis is seen in both eyes; in the left there is a considerable effusion of lymph