. Diseases of the nervous system : for the general practitioner and student. ly there is scoliosis and compres-sion of the cord and roots; the destruction of the latter is very laminectomy is urgent. (5) Tumors may also originate in the rootsand in their meningeal coverings. Multiple fibromata are localized inthe roots (neurofibromatosis) and they are most frequently found in thenerves of the cauda equina. The posterior roots are oftener involvedthan the anterior ones. Solitary fibromata are not accompanied by diffuse COMPRESSION OF THE CORD 307 neurofibromatosis; their point of d
. Diseases of the nervous system : for the general practitioner and student. ly there is scoliosis and compres-sion of the cord and roots; the destruction of the latter is very laminectomy is urgent. (5) Tumors may also originate in the rootsand in their meningeal coverings. Multiple fibromata are localized inthe roots (neurofibromatosis) and they are most frequently found in thenerves of the cauda equina. The posterior roots are oftener involvedthan the anterior ones. Solitary fibromata are not accompanied by diffuse COMPRESSION OF THE CORD 307 neurofibromatosis; their point of departure is the dura. The mostfrequent seats of meningeal tumors are the dorsal region and the caudaequina. The state of the nervous tissue in cases of slow compression by a tumorlying externally to the cord is as follows: The cord is flattened or presentsa depression. It is pale or else congested. At the level of compressionthe myelin is broken up, the axis-cylinder disappears; instead of it neu-roglia proliferates and around the blood vessels connective tissue prolifer-. Fig. 101.—Tubercular Pachymeningitis. A Case of Tuberculoma of the Cord. {Original.) ates; the affected segment is therefore in a state of sclerosis. Above andbelow this level ascending and descending degeneration develops. Thecells of the gray matter at the point of pressure are either in a state ofatrophy or completely absent. The meninges are thickened and tumors of the cord and meninges, even the most malignant ones,do not produce metastasis. When they originate in the vertebrae, meta-stases are not rare. In Potts disease the destructive tubercular process of the bone (pusand fungosities) perforates the posterior vertebral ligament and reachesthe dura; the latter becomes inflamed and proliferates (pachymeningitis),The tubercular masses covering the dura undergo softening, form smallpurulent collections at first, then later constitute a large abscess. Onthe other hand the tubercular mass
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectnervous, bookyear1913
