The primary intradural tumours of the optic nerve (Fibromatosis nervi optici) / by W. Gordon M. Byers.

  • Byers, W. Gordon M. (William Gordon Matthew)
Date:
[1901]
Catalogue details

Licence: In copyright

Credit: The primary intradural tumours of the optic nerve (Fibromatosis nervi optici) / by W. Gordon M. Byers. Source: Wellcome Collection.

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

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    PATHOLOGICAL ANATOMY. Gross ANATOMv.-The intradural tumours of the optic nerve though varymg in minor details, possess in general a very characteristic structure. g^'icrai, a It necessarily follows from our classification that in everv instance the capsule is formed by the dural sheath. As s s a a rule, this structure as it surrounds the tumour, forms a uniform covering varying from 0.5 to i mm. in thickness, which can be readily stripped away from the structures beneath; but as a common exception the capsule is thickened and adherent as it passes over the surface of the enlargement or, on the other hand, thinned and attenuated, even—thouo-h rarely, to the extent of perforation (Alt,=^ Rockliffe^^). In a cate which the writer studied for Dr. Buller,^^ there was present m addition to the clearly defined dural sheath, and external to It, a second less dense and shaggier capsule, which was looked upon as the layer of fascia normally present between the optic nerve and the orbital fat. These intradural tumours of the optic nerve vary con- siderably in size, and generally speaking, this depends upon the length of the period of development, though it frequently happens that a discrepancy exists betweea the symptoms present and the size of the growth. The tumour of Seggelwas so' small as to cause no appreciable bulging of the nerve, while on the other hand the specimens of Lidell' and Kunacho- witch -^^ had attained the dimensions of a goose egg. A considerable difference is also present in the form of these growths, depending upon the situation and extent of the new tissue growth in the subvaginal space as well as upon the changes in the nerve proper. What is generally the case is, that a piece of normal or uniformly enlarged optic nerve exists between the globe and a more or less marked swelling upon the posterior two-thirds or thi^ee-fourths of the nerve, and the commonest appearance produced is that of a pear, Indian club, leg of mutton or nuts of different kinds. In not a few instances the normal spiral curve of the anterior part of the nerve is considerably exaggerated and the tumour then looks like the classic Horn of Plenty. Braunschweig is not correct in saying that the reverse condition is common, in which the greatest development is along the artterior part of the nerve, and a pedicle extends between it and the optic foramen.