Organic and functional nervous diseases; a text-book of neurology . o a dense mass which impinges directly upon the spinal upon the cord primarily affects its bloodvessels and producesa condition of ischsemia which may be sufficiently intense to go on tonecrosis. Where the pressure is not very severe, this ischsemic con-dition, while sufficient to cause a lack of general nutrition of the cordat the point of pressure, is not enough to set up true destructive ordegenerative processes; and while symptoms, such as increase of thereflexes below the level of the lesion, some degree of
Organic and functional nervous diseases; a text-book of neurology . o a dense mass which impinges directly upon the spinal upon the cord primarily affects its bloodvessels and producesa condition of ischsemia which may be sufficiently intense to go on tonecrosis. Where the pressure is not very severe, this ischsemic con-dition, while sufficient to cause a lack of general nutrition of the cordat the point of pressure, is not enough to set up true destructive ordegenerative processes; and while symptoms, such as increase of thereflexes below the level of the lesion, some degree of motor weaknessand stiffness of the limbs, slight parsesthesise, and possibly severe painof a girdle nature in the domain of the spinal nerves whose roots arecompressed, may remain for some time, yet, if the pressure is relievedby healing of the process or by removal of the mass, they may subsideand a restoration of function in the cord may ensue. In some cases,however, the pressure produces a true constriction of the cord whichis visible at the autopsy. Fig. Epidural tuberculosis. The cord is tightly surrounded by the thickened with a hand-glass. (Schmaus-Sacki.) Microscopic examinaticjn of the cord opposite the point of suchpressure does not, as a rule, show necrosis rather than is a swelling of the axis cylinders, a segmentation of the myelinsheath with fatty drops, a disappearance of the nerve fibres, withsecondary hyperplasia of the glia, and a production of scleroticpatches. The cells of the cord at this point are often atrophied andfound in various stages of degeneration, chromatolysis, and vacuoliza-tion. In more advanced stages of the disease this results in a disap-pearance of the nerve fibres and cells, whose place is taken by smallcells, small nuclei, and thickened gliomatous tissue, with an increaseof connective tissue about the blood-vessels. Corpora amylacea andDeiters cells are often found in the mass. In the terminal stage
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectnervoussystem, bookye
