Otitic cerebellar abscess / by Heinrich Neumann ; translated by Richard Lake.

Date:
1909
Catalogue details

Licence: In copyright

Credit: Otitic cerebellar abscess / by Heinrich Neumann ; translated by Richard Lake. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    process ; why sinus thrombosis, cerebral abscess, or extra- dural abscess, appear, is dependent partly on the route of infection, partly on the virulence of the infective agent. Suppurative processes of slight virulence tend chiefly to adhesions of the cerebral meninges, which form a dam against the progress of the infection ; whilst, on the other hand, the effects of highly virulent exciting causes evince a tendency to rapid progression, even before adhesion of the disease focus with the meninges takes place. The route by means of which infection from the temporal bone reaches the cranial cavity is of material significance as regards the variety of cerebral complication produced. If the infection travels by pre-existing tracts, diffuse meningitis, due to purulent infection of the meninges, occurs in the majority of cases, before adhesion can take place. Suppuration induced in this manner leads only in the rarest cases to cerebral abscess. The aquaeductus vestibuli apparently forms an exception to this rule, as inflammatory processes are propagated in a similar manner to those spreading by way of newly-formed channels. The fistulae formed by carious destruction advance but slowly towards the cranial cavity, owing to which, with this mode of infection, as a rule localized collections between the cerebral orifice of the bony fistula and the adjacent meninges occur. This applies to the aquaeductus vestibuli, the inner opening of which is covered by a layer of dura. If the infection travels by way of the aquieductus vestibuli, as a rule an empyema of the sacculus is formed in the first place, practically an interdural abscess, owing to which adhesions occur between the dura and the soft coverings of the brain in relation to the surface of the cerebellum. Infection via pre-existing tracts (with the exception of the aquaeductus