Tumour of the brain : congestion papilla.

  • Swanzy, Henry R. (Henry Rosborough), 1843-1913.
Date:
1871
Catalogue details

Licence: Public Domain Mark

Credit: Tumour of the brain : congestion papilla. 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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    [Reprinted from the Dublin Quarterly Journal of Medical Science—February, 1871.] / ■ - ■ TUMOUR OF THE BRAIN; CONGESTION PAPILLA.' Mr. Swanzy said the case which he was about to bring under the notice of the Society was of interest to the physician as well as to the oculist. The patient was a private in the Scots Fusilier Guards. On the 18th of April last, having fallen out faint on the march, he was admitted to hospital in Beggar’s Bush Barracks. On admission he was in a heavy, listless state ; complained of headache, giddiness, and much vomiting; his pupils were widely dilated. From this time until the 18th of August, when the patient died, the general symptoms consisted in constant headache, fre- quent vomiting, great drowsiness, and loss of memory, so that he often forgot having had his meals. If asked a question it would be some moments before he would reply, and then his articulation was very slow but distinct. The bowels were very torpid, making the use of purgatives frequently necessary. During his illness of four months these symptoms were sometimes more and sometimes less aggravated. At one time he so far recovered as to be able to take a short walk in the barrack yard ; but on the next day he was obliged to return to bed. About a month or six weeks after his admission to hospital Dr. Robinson asked him (Mr. Swanzy) to see the patient. He found the pupils widely dilated, and in the left eye all power of perception of light was lost. In the right eye there was still a slight power of perception of light. The ophthalmoscope revealed that condition of the optic disc described by von Graefe as congestion papilla. This led him to diagnose an increased intracranial pressure, dependent, probably, upon the presence of a tumour within the cranium. The ophthalmoscopic appearances were very similar to those represented in Fig. 2, Table XI., of Liebreich’s Ailas^ and were beautifully depicted by Dr, Fitzgerald in the drawings taken during life. There was a great tumefaction of the optic disc. The tumefaction was very prominent, but did not extend far into the surrounding retina. The retinal* veins were very much engorged, and very tortuous in their course. They disappeared ^ Read before the Dublin Pathological Society, December 10th, 1870. ^ Liebreich’s Atlas of Ophthalmoscopy. Translated by H. R. Swanzy. London : 1870.