Nervous and mental diseases . ess is purely inflamma-tory, are very vague. In manycases no suspicion of the diseasehas been raised during life. The first recognizable symptoms attendthe formation of a hematoma large enough to produce cerebral indica-tions. These consist of pain in the head, intellectual troubles, loss ofmemory, awkwardness in muscular movements, insomnia, vertigo,rarely vomiting, limited or Jacksonian convulsions, apoplectiform attacks,rigidities and monoplegias presenting remissions. The temperature isfickle and uninstructive. During the convulsive attacks it attains ahigh de
Nervous and mental diseases . ess is purely inflamma-tory, are very vague. In manycases no suspicion of the diseasehas been raised during life. The first recognizable symptoms attendthe formation of a hematoma large enough to produce cerebral indica-tions. These consist of pain in the head, intellectual troubles, loss ofmemory, awkwardness in muscular movements, insomnia, vertigo,rarely vomiting, limited or Jacksonian convulsions, apoplectiform attacks,rigidities and monoplegias presenting remissions. The temperature isfickle and uninstructive. During the convulsive attacks it attains ahigh degree, but in the intervals may be subnormal, normal, or slightlyelevated. Course.—As the early symptoms escape recognition, the durationof the disease is indeterminate. It usually runs a protracted course,and may in rare instances terminate in recovery, with resorption of mostof the new tissue. As it is practically an expression of a serious orhopeless underlying condition, the ordinary end is death. This may 1 Brain, Fig. 26.—Pachymeningitis interna in a rachiticchild with scurvy. The different layers, with cotton-wool pledgets interposed, are seen onthe right side ofthe skull anteriorly (Southerland). 76 DISEASES OF THE CEREBRAL MENINGES. follow an apoplectiform seizure or a comatose condition, but usually ispreceded at intervals by a number of such attacks, each of which leavesa certain trace behind it in the form of added mental or motor dis-ability. Diagnosis.—The diagnosis is difficult. In drunkards, dements,and cachectic children the appearance of the cerebral symptoms men-tioned should call the disease to mind. A history of preceding apoplec-tiform attacks, with practically complete remissions, would strengthenthe suspicion. The thickened membranes form anatomically a subduraltumor, and at times present all the symptoms of a new growth in thatlocality. The nocturnal cephalalgia of syphilitic meningeal involvementand other luetic features will usually differ
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Keywords: ., bookcentury1900, bookdecade1910, bookid, booksubjectnervoussystem
