Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson.

  • Sternberg, Maximilian, 1863-
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Acromegaly / by Maximilian Sternberg ; translated by F.R.B. Atkinson. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    dura mater becomes stretclied, and thinner (Claus and Yan der Stricht). The infundibulum and tuber cinereum are absorbed in the new growth, which grows upwards on the pedicle of the former to a certain extent. The canal of the infundibulum is dilated. The tumour now makes its bed in the excavated base of the brain. While the tumour lies in the region of the tuber cinereum the chiasma is pushed forwards. Anteriorly, in large tumours,* the frontal lobes may be compressed, laterally the gyrus uncinatus (Gauthier, Claus, and Yan der Stricht), posteriorly the pedun- culi cerebri with the oculo-motor nerves, as far as the pons (Cunningham). The cavity of the fourth ventricle may also be encroached upon, and the nucleus of the oculo-motor thereby damaged (Uhthoff). The changes in individual parts depend upon the configuration of the upper surface of the tumour. Frequently this is developed asymmetrically, projects, for example, on one side into the middle fossa of the skull, and draws in with it the one branch of the oculo- motor nerve (Arnold). It may push forwards the tubercles and secondary nodules, which may here destroy the external part of the chiasma (Dallemagne). The chiasma is usually compressed into a kind of band, its breadth may amount to 1*5 cm., the thickness at the same time from 1—2 mm. The optic nerves also become compressed, very frequently asym- metrically (Fritsche-Klebs, Arnold, Dallemagne). The optic tracts become excessively wasted: in Roxburgh’s and Collis’ case the left had entirely disappeared. Yarious degrees of degeneration are present in the com- pressed nerves. Of the organs of the senses there is little reported. Klebs found the eyeball enlarged, Marie and Marinesco the papilla and retina atrophied. We have spoken above of the osseous part of the aqueductus vestibuli as well as of the degenera- tion of the cutaneous nerves. Of the respiratory organs, the mucous membrane of the nose is frequently thickened, the vessels are dilated. The turbinated bones protrude into the pharynx. The larynx and epiglottis may be enlarged in all dimen- * To give an idea of the often considerable size of the tumour, the case of Mosse' and Daunic may be quoted : Length, 6 cm.; breadth, 7 cm.; weight, 36‘0 g.