File:Diseases of the nervous system - for the general practitioner and student (1913) (14786162483).jpg

Identifier: diseasesofnervou00gord (find matches)
Title: Diseases of the nervous system : for the general practitioner and student
Year: 1913 (1910s)
Authors: Gordon, Alfred, 1869-1953
Subjects: Nervous System Diseases
Publisher: Philadelphia : Blakiston's Son
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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of cases of cerebral hemorrhage the altered vessel wallwill rupture under the influence of raised blood pressure and this occursin severe muscular efforts, as, for example, in lifting heavy weights, inthe act of difficult defecation, in parturition, in paroxysms of severe cough,coitus, attacks of anger, excitement, etc. Finally, intra-cerebral hemor-rhage may occur irrespective of arterial alterations, namely from injuriesto the head: fractures of the skull, blows or a simple contusion. Hemor-rhages on the surface of the brain are usually the result of direct cranial,trauma, although it may occur under the conditions related above. 86 APOPLEXY B. SOFTENING OF THE BRAIN (EMBOLISM AND THROMBOSIS) Pathology.—Cerebral softening is the result of an interruption of bloodsupply which is usually produced by an embolus or thrombus. When thisoccurs, the first effect will be a local anemia and a change in the consistencyof the tissue supplied by the obstructed vessel. At the end of twenty-four
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Fig. 63.—Extensive Softening in the Left Hemisphere, Involvtvg the InternalCapsule, Basal Ganglia and Corona Radiata. (Original.) hours effusion of serum (oedema), breaking up of nerve elements andsoftening take place. The color of the affected area is at first white be-cause of the local anemia, but later on, when the return circulation isestablished, some corpuscles escape with the serum under high pressure APOPLEXY 87 into the tissue and give the softened area a red color (red softening)which still later (in the fourth week) changes to yellow because of the de-generative changes in the effused blood. Yellow and red softening isobserved chiefly in the convolutions, viz. in the gray matter; whitesoftening in the white substance of the brain. In but a few days after an onset the brain tissue is in a state of de-generation. Cells, neuroglia, myelin are dissociated, and the leucocyteswhich escape from the capillaries are in abundance. The entire affectedarea undergoes fatty degenerati

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