Observations relative to the state of the skull and of the brain in congenital chronic hydrocephalus, and to idiocy and paralysis attending it : with cases / by Francis Battersby, M.B.

  • Battersby, Francis.
Date:
1851
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Licence: Public Domain Mark

Credit: Observations relative to the state of the skull and of the brain in congenital chronic hydrocephalus, and to idiocy and paralysis attending it : with cases / by Francis Battersby, M.B. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the cerebral comuiissare. The organic disposition of which Bianchi and Carlisle have spoken, arc to be attributed to a deformity pro- duced by the presence of liquid in the lateral and third ventricles. The former found in a child, seven years old, a single cerebral cavity, in which were to be seen confounded the corpora striata and optic thalami. The conarium and choroid plexus were want- ino-, as well as a part of the medidla oblongata. The tubercula quadrigemina and cerebellum were natural. The brain was formed of cineritious substance only, the medullary being gene- rally wanting. There was no trace of septum lucidum nor of the corpus callosum. In a woman, aged twenty years, Carlisle found the brain unilocular, and the corpus callosum scarcely apparent. In this subject the intellectual faculties offered nothing particular, whilst in Bianchi's case there was perfect idiotcy.* I shall now proceed to show the manner in which external hydro- cephalus was produced in the cases recorded of it in the writings of British practitioners. Dr Monro says, An anatomist, reason- ing a p7'iori, would be apt to suppose that the water in hydroce- phalus internus should be as often found immediately within the' dura mater, between it and the outer surface of the brain, cere- bellum, and spinal marrow, as within the ventricles of the brain. Experience, however, proves that it is generally collected within the ventricles; and as I have not met with a single instance in which the water was entirely on the outer side of the brain (al- though I am far from doubting the possibility of the fact), I can- not help suspecting that this happens much more rarely than is supposed by authors, and that in many cases, supposed to have been of this kind, the brain had been lacerated in opening the cranium, and the water by that means had become effused on the surface of the brain.'-f' In not one of the recorded cases was the fluid originally external, except in La Motte's^ case, in which it does not appear whether there was or not a post mortem exami- nation. Dr Craigie's remarks on this subject are very deserving atten- tion.§ He considers the inner surface of the ventricles to be the original situation of the fluid in chronic cerebral dropsy, and states that there are two cases in which it may get out of that situation, and insinuate itself between the outer surface of the brain and the dura mater. The first is where the process of serous effusion commences at a period so early in fcetal existence that it precedes the full de- velopment of the brain, suddenly arrests the process of develop- ment while the pia mater and choroid plexus communicate freely, ' Breschet, loc. cit., p. 529. t On the Brain, the Eye, and the Ear, p. 33. 1797. J Traite eomplet de Chirurg. T, i. Obs. 115. § Loc. cit-, p. 22. B