A case of lesion of the optic thalamus with autopsy / by Gordon Holmes and Henry Head.

  • Holmes, Sir Gordon Morgan, 1876-1965.
Date:
1912
Catalogue details

Licence: In copyright

Credit: A case of lesion of the optic thalamus with autopsy / by Gordon Holmes and Henry Head. 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.

    4/20 (page 256)
    Oil the other hand, it must be recognized that this syndrome, which Dejerine and Koussy have described most fully, is probably associated with lesions of this portion of the thalamus only, and that disease of other parts of this mass of grey matter may produce essentially different clinical phenomena. The following case, in which we had the opportunities of full clinical and pathological investigations, evidently belongs to the Dejerine-Koussy group. W. H., aged 49, was admitted to the National Hospital on August 23, 1909, into one of Dr. Ormerod’s beds, but owing to Dr. Ormerod’s absence he was, whilst in hospital, under the care of one of us (G. H.). He was a blacksmith, and had until recent years been in good health. He denied alcoholic excess and venereal infection. The history he gave of his illness was confirmed and amplified by his wife. The first evidence of any cerebral disease was a temporary difficulty in speech in February, 1906, from which he recovered completely within three days. He had an attack of “influenza” in the autumn of 1908, but was soon able to resume his work, at which he remained till early in 1909, when he had to cease owing to vertigo and a feeling of general weakness. He had complained since then constantly of these symptoms. In February, 1909, while talking to his wife, he suddenly fell to the ground and lost the power of movement in his right limbs and the right side of his face, but there was no loss of consciousness. He recovered rapidly and was soon again able to use the right limbs quite well. In June, 1909, he had another similar attack, and a third on July 1. The right limbs were weaker after each of these attacks, but he remained able to move them, though he could not employ his right hand in feeding himself, or in other fine actions. Speech was not noticeably affected and the patient’s general mental condition did not alter materially. From the date of the first attack, however, he com- plained much of headache and vertigo. On the evening of the day on which he was admitted to hospital he became maniacal and violent and had to be removed to the isolation ward. Next day, however, he was quiet, collected and easy to examine. His mental state improved further and for a few days he remained in a condition fairly suitable for our investigations. He was a sallow, lean man with marked arcus senilis, rigid arteries and a high pulse tension; his heart was hypertrophied, and Ins urine was of low specific gravity and contained a small amount of albumen. He appeared much older than his age. His memory was poor, and, as he was inclined to become inattentive after a time, it was necessary to interrupt the examination fre- quently. There was no trace of aphasia or apraxia. His ocular movements were normal: the pupils were equal but small, and inactive to light. The movements of the jaw were unaffected, and there was no