Cerebellar abscesses of otitic origin in nine children : eight recoveries after cannulation / Frederic Schreiber.

  • Schreiber, Frederic.
Date:
[1941], ©1941
Catalogue details

Licence: In copyright

Credit: Cerebellar abscesses of otitic origin in nine children : eight recoveries after cannulation / Frederic Schreiber. Source: Wellcome Collection.

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    Number 3 CEREBELLAR ABSCESSES withdrawn to avoid traumatizing the cerebellum when the child moved. During a rapid postoperative recovery the child’s papilledema disappeared within a week and the ataxia within a month. After five years of apparently normal health the child was again admitted to hospital with a stiff neck and high fever. Pneumococci were recovered from blood and spinal fluid and four days later patient expired from septicemia and menin¬ gitis. Case 2.—Margaret L., age eight, was admitted to hospital, seven weeks after an opening of both eardrums, with painful and discharging ears. After a double mastoidec¬ tomy the child continued to be drowsy, with nausea, headache and weakness of left arm. Fig. i.—Billy IT., Case g: Showing recent scar over trephine open¬ ing. Patch of adhesive marks occipital protuberance. Right mastoid region was reopened 12 days after mastoidectomy, the dura uncovered, and the right temporal lobe needled for a suspected abscess without obtaining pus. Several spinal punctures around this time showed 50 to 100 cells, mostly lymphocytes. Patient was first seen by the author the day following reopening of right mastoid region. Child was semicomatose; pulse 60, temperature 99.6° F. Atonia and ataxia in left arm with early choking of optic disks. At operation upon the left cerebellar lobe, 45 cc. of thick greenish pus were allowed to escape from abscess whose wall was encountered at a depth of 3 cm. Pulse rose from 74, preoperatively, to 134, postoper- atively, and child seemed improved. Culture: Streptococcus hacmolyticus. After 11 days of stormy convalescence the child became unconscious, cyanotic, and pulse rate dropped to 60. Twenty-five cc. of glucose were administered, and patient immediately became conscious. After seven years this patient was getting along well in school and no neurologic abnormalities could be found. Case 3.—Harry C., age five, was readmitted to hospital, 15 days after a left mas¬ toidectomy, with complaint of vomiting and headache, but did not appear acutely ill. Pulse 100; temperature normal; R.B.C., 3,150,000; W.B.C., 17,200. Spinal tap revealed clear fluid under increased pressure, with 76 cells. Culture: Staphylococcus. Following spinal tap, the child complained of neck pain, its head was retracted and its condition became rapidly worse. Seen by author on following day, the child was drowsy but cooperative, his pulse varied around 60, the fundi showed early choking of the disks, and there were marked