File:Modern surgery, general and operative (1914) (14779263881).jpg

Identifier: modernsurgerygen1914daco (find matches)
Title: Modern surgery, general and operative
Year: 1914 (1910s)
Authors: Da Costa, J. Chalmers (John Chalmers), 1863-1933
Subjects: Surgery Surgery, Operative
Publisher: Philadelphia, London, W. B. Saunders company
Contributing Library: Columbia University Libraries
Digitizing Sponsor: Open Knowledge Commons

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ium.There may be clinical evidences of syphilis. There should be a positive Was-sermann reaction. Diagnosis of Intracranial Tumors 813 Chronic tuberculous meningitis causes a headache which is apt to be generaland more violent than that of tumor, and there is more commonly cutaneoushyperesthesia and hyperesthesia of the organs of sight and hearing. Opticneuritis may be absent. When present it is of less intensity than that observedin tumor. In some cases the ophthalmoscope discloses tubercles on the choroid.In meningitis there is a continued, irregular fever. The cerebrospinal fluidobtained by lumbar puncture usually exhibits an excess of lymphocytes. Itmay contain the bacilli. Carbohydrate is absent. It may be sterile. Ofcourse, a tumor might exist with meningitis. In Brights disease symptoms strongly suggestive of tumor may arise(headache, vomiting, and choked disk) with, perhaps, but little change in theurine. The difficulty in diagnosis becomes evident when we recall that in cases
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Fig. 524.—Professor Gibbons case of brain tumor. of brain tumor the urine may contain casts and albumin. A sudden onset andbrief duration of the symptoms suggest uremia. Ependymitis with ventricular dropsy may cause s^Tiiptoms resemblingtimior with hydrocephalus. Optic neuritis is not so common as in tumor.Bilateral spastic paralysis may arise. Severe anemia is capable of producing symptoms which suggest tumor.It can even produce choked disk. A blood examination and the rapid im-provement under proper treatment makes the diagnosis e\ddent. In some cases of brain tumor (especially frontal lobe tumors) there arestriking evidences of hysteria and neurasthenia. Always think of this wheninclined to make a diagnosis of hysteria or neurasthenia. The .T-rays may aid us in diagnosis and many brain tumors can be skia-graphed (Fig. 524). Lumbar puncture ma)^ aid in the diagnosis, but it must be 8i4 Diseases and Injuries of the Head used with the greatest care, because in tumor the withdrawal o

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