Retinal embolism, homonymous hemianopsia, and double optic neuritis, in cases of anaemia / by C. O. Hawthorne.

  • Hawthorne, C. O. (Charles Oliver), 1858-1949.
Date:
[1904]
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Licence: In copyright

Credit: Retinal embolism, homonymous hemianopsia, and double optic neuritis, in cases of anaemia / by C. O. Hawthorne. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    symptoms as delirium, coma, paralysis, and optic neuritis terminates in death, and the discovery of sinus-thrombosis on post-mortem examination. And, to quote again from Professor Welch's article, not very infrequently after death in one or more of the intracranial sinuses thrombi are found which had occasioned no recognisable symptoms during life. There is, therefore, a double answer to the objection that sinus-thrombosis cannot be the cause of optic neuritis in chlorosis because there occurs with the neuritis no other evidences of cerebral disturb- ance. In the first place this objection as a statement of fact is not wholly accurate, and secondly sinus-thrombosis, as the above quotation testifies, may exist and yet may fail to produce any such evidences. It is therefore conceivable that it may cause optic neuritis as its sole and unaccompanied clinical conse- quence. But it may be said that the fact stated by Professor Welch proves too much, so far as the present argument is concerned. If sinus-thrombosis may be discovered after death in persons who during life did not show optic neuritis, this, it may be held, is a demonstration of the incapacity of sinus- thrombosis to cause optic neuritis. But intracranial tumours are exactly in the same position. Some of these are, and some are not, accompanied by optic neuritis, and occasionally such a tumour is discovered after death though during life no suspicions of its presence existed. Now the absence of optic neuritis from some cases of brain-tumour will not be advanced against the doctrine that intracranial tumours may, and frequently do, cause optic neuritis. Equally the absence of optic neuritis from some cases of sinus-thrombosis does not prove that this condition can never number optic neuritis among its conse- quences; In short, the non-occurrence of optic neuritis in arterial thrombosis, its absence from some cases of sinus- thrombosis, and its development in chlorosis apart from other cerebral symptoms, neither separately nor together render untenable the position that the optic neuritis which is seen in some cases of chlorosis is in all probability due to the occur- rence of thrombosis within some of the intracranial veins or sinuses. The case (Case 4) reported with this article is, as already stated, merely one further example of optic neuritis in chlorosis without any feature specially assisting the solution of the clinical problem presented by such a combination. It