. A treatise on the nervous diseases of children, for physicians and students. of the vermis are responsible for a tendency to fallforward or backward. A cerebellar tumor may be of very small size and yetsufficiently large to compress the sixth, seventh, and eighth nerves, and in itsfurther growth may produce involvement of the bulbar nerves as well, just astumor of the bulb may also produce cerebellar symptoms. The affection of 480 THE NERVOUS DISEASES OF CHILDREN the sixth nerve, causing paralysis of the rectus externus, is extremely commonin cerebellar tumors, and in some cases the diagnosi
. A treatise on the nervous diseases of children, for physicians and students. of the vermis are responsible for a tendency to fallforward or backward. A cerebellar tumor may be of very small size and yetsufficiently large to compress the sixth, seventh, and eighth nerves, and in itsfurther growth may produce involvement of the bulbar nerves as well, just astumor of the bulb may also produce cerebellar symptoms. The affection of 480 THE NERVOUS DISEASES OF CHILDREN the sixth nerve, causing paralysis of the rectus externus, is extremely commonin cerebellar tumors, and in some cases the diagnosis of cerebellar tumor maybe corroborated by the early involvement of the seventh and eighth nerves(Fig. 121). Of late years, Monakow, Sternberg, Oppenheim, Fraenkel, and Hunt havecalled attention to slowly growing tumors (neuromata and neurofibromata)in the cerebello-pontile angle, involving one or more cranial nerves, especiallyboth auditory nerves. Cerebellar symptoms are preceded, often for manyyears, by those pointing to involvement of the auditory, the trigeminal, the. Fig. 121.—Tumor (Sarcoma) of the Cerebello-Pontile Angle. Early appearanceof facial and auditory nerve symptoms. vagus, of one or both sides. I have under observation at the present time ayoung girl who, for years past, has suffered from central deafness, ataxia ofthe right upper extremity, dizziness, and who now is also completely blindfrom double optic neuritis. The general manifestations of cerebellar tumors do not vary much fromtumors in other parts of the brain; but if the growth encroaches upon thepyramidal tracts in the pons and medulla unilateral or bilateral paralysis willfollow. The reflexes are sometimes exaggerated, as in all other cerebraldiseases, but in not a few cases the knee-jerks are either diminished orabsent. Differential Diagnosis.—The diagnosis between tu-mor and abscess will depend upon the frequent presence cffever, and upon the very slow invasion and slow develop-ment of all the
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