Internal hydrocephalus in the adult, with remarks on the aetiology of hydrocephalus and its occasional association with other abnormal conditions of the central nervous system / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1902
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Licence: In copyright

Credit: Internal hydrocephalus in the adult, with remarks on the aetiology of hydrocephalus and its occasional association with other abnormal conditions of the central nervous system / by F. Parkes Weber. 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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    both eyes (on the right side more than the left). Stiffness in the cervical region of the spine was complained of soon after admission, at one time suggesting caries in the upper cervical vertebrae. The stiffness was more marked for rotation than for flexion of the head. There was no evidence of disease in the thoracic or abdominal organs, excepting the gastric disorder noted above. The patient did not seem to be hysterical. She was decidedly intelligent and quick at understanding, and could sing. There was no evidence of syphilis, either congenital or acquired. With the exception once or twice of an evening temperature of 100°F. fever was absent throughout. Mercurial inunction was tried with doubtful result. The patient, however, gradually improved; the cervical rigidity com- pletely disappeared, and she was able to be up and get about in the ward and was thinking of leaving the hospital. In November the patient’s troubles to some extent returned, and mercurial inunction was tried again. Pepsin was likewise given to aid digestion. Dr. Leonard Williams, who kindly took charge of the case during my absence, found her complaining of headache, vomiting and weakness. There was slight nystagmus on extreme lateral deviation, which was ill sustained. Optic neuritis in both eyes. The knee jerks were present, equal, and active. No clonus. The plantar reflex was of the flexor type. Dr. Williams found slight ataxia in one of the upper limbs. Vertigo was not a very prominent symptom of the case, but the sister of the ward says the patient on lying down after a bath would sometimes feel giddy and then suddenly vomit. Her gait was hesitating, rather that of a weak person taking small steps than that of a patient with cerebellar tumour or tabes. Deafness was not a symptom in the case.1 Neither was there any mental disturbance such as occurs in general paralysis, nor any form of insanity such as has been observed in some cases.2 On December 7, 1901, at about 6.30 a.m., the patient was suddenly seized with violent vomiting and frightful headache, and this was followed by general rigidity and clonic convulsive movements, death occurring about 7.30 a.m. The pulse during the seizure was infrequent but regular, and the face was flushed at the end. 1 it was in Hilton’s case and in that of Burr and McCarthy, both of which I have quoted later on. 2 See Burr and McCarthy’s case quoted later on. See also Dr. T. Whipham’s account of a man, aged 39, with hydrocephalus and insanity {Trans. Clinical Soc. of London, 1884, vol 17, p. 191.) Dr. Whipham’s case was not merely one of passive hydrocephalus or “ hydrocephalus ex vacuo,” as there was flattening of convolutions over a portion of the brain.