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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    the lungs were not examined ; otherwise the lesion found post¬ mortem must have been detected. The apices were caretully examined, as I suspected the intra-cranial disease to be tubercular.) The diagnosis was an intra-cranial tumour. Tlie position^ ot the tumour could not be ascertained as there were no localizing symptoms. From the associated condition of the wrist joint, and from the age of the patient, it was thought to be scrofulous. ^ Treatment.—A mixture containing iodide and bromide of potassium was prescribed. Tincture of iodine was painted over the swollen wrist, and it was supported by a splint. Subsequent progress of the case.—On March \0th it was noted . He is apparently (^uite well. There has been no headache foi several nights. Indeed, so w^ell did he seem that the nurse re¬ peatedly asked me wliy I did not send him home. He continued well until March 20th, when an internal squint in the right eye was noticed ; the eyeball was turned inwards and upwards, and the squint was increased by looking at distant objects. The dose of iodide was increased to 10 grains. On March 2Qth it was noted For some days past he has been dull and heavy, and has slept a great deal. The left wrist joint was to-day opened under antiseptic precautions j a quantity of thick cheesy pus was evacuated. On April 5th he had a series of severe general convulsions; both sides of the body were affected, the left more powerfully than the right. The convulsions continued more or less for three hours. On April 6th he looked pale, but seemed otherwise much as usual. The squint was less marked, and on April 20th it had disappeared. For the next two months he remained in a passive state, making no complaint, eating voraciously, and sleeping too constantly. He gradually became more dull and stupid. His eyesight failed, and the ophthalmoscope showed the steady progress of optic atrophy. All this time the body continued to be well nourished, and there was not now^ nor at any subsequent period^ until after the final convulsion^ the slightest trace of paralysis. On 66th June an herpetic eruption appeared underneath the left eyelid. On Ath August he vomited several times without any obvious cause. On Vjth August he was seized with convulsions; the spasms again chiefly affected the left side. After the attack the left arm and leg were found to be paralyzed. The patient remained in a semi-comatose condition until 21st August, when he died at 11.30 P.M. The post-mortem was made nineteen hours after death. The body was well nourished. There was nothing noteworthy in the external appearances. Head.—The scalp, bones, and membranes were natural. There was evidence of great intra-cranial tension, the convolutions being