A contribution to brain surgery with special reference to brain tumors / by M. Allen Starr.

  • Starr, M. Allen (Moses Allen), 1854-1932.
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: A contribution to brain surgery with special reference to brain tumors / by M. Allen Starr. 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.

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    able, for it is not sufficient to evacuate the cyst which then refills, but its wall must be dissected out; and this can rarely be done without serious injury to the brain, which may be followed by hemorrhages or by the formation of an abscess. Thus in a case operated upon by Dr. McBurney for me in January, 1895, in which headache and attacks of spasms, beginning in the arm and extending to the face, then to the body, and finally becoming general, were the chief symp- toms, these symptoms having developed subsequently to a blow on the head, which had not produced any fracture, trephining over the arm area revealed the presence of a cyst containing about two drachms of clear fluid. The wall of this cyst was removed. Two days later a gradually increasing hemiplegia and men- tal dulness indicated the existence of compression which was found on investigation to be due to a hem- orrhage that had occurred from a small vein of the pia subsequently to the operation. About eight ounces of blood clot were removed from the surface of the brain, with immediate subsidence of the mental dul- ness and of the hemiplegia. The patient then went on to recovery and remained well for five months, when the spasms recurred. Investigation showed that another cyst had formed at the seat of the old one. This was evacuated and the attempt was then made to secure its healing from the bottom by packing and an open dressing. This appeared to succeed, but at the end of six weeks, when only a very small sinus remained, the boy suddenly went into a condition of coma and died, and the autopsy showed a third cyst which had formed beneath the others, had invaded a large area of the brain, and had ruptured, causing death. The cases reported from Australia, of cysts that are evacuated, are largely of the hydatid variety which we do not see in America. Many of these cases . recover and do not recur. In regard to glioma, it is to be stated that in order