Identifier: somepointsinsurg00ball (find matches)
Title: Some points in the surgery of the brain and its membranes
Year: 1907 (1900s)
Authors: Ballance, Charles Alfred, Sir, 1856-1936
Subjects: Brain Brain Neoplasms Brain Abscess Brain
Publisher: London New York : Macmillan
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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n. No patient should be allowedto become blind from optic neuritis. A woman, aged forty-one years, was admitted to theNational Hospital, under Dr. Buzzard, with symptomspointing to tumour pressing on the internal capsule :hemianassthesia, hemiplegia, severe headache, and failingsight from optic neuritis. She became comatose aftera paroxysm of pain. I opened the skull and dura.Consciousness returned, and the headache, optic neuritis,and vomiting were completely relieved. There waseven, a month later, some return of power and sensationin the paralysed limbs. Again, a man of forty was admitted to the NationalHospital, under Dr. Buzzard, with agonising headache,vomiting, and intense optic neuritis. For certainreasons the tumour was located in the left cerebellarhemisphere. I removed the bone and dura over thisregion, but found no tumour. The man recovered andreturned to work. He died eighteen months later,when a large tumour was found in the right frontalregion. OF TUMOUR OF THE BRAIN 171
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Fig. Fig. 76. Figs. 73, 74, 75, and 76.—The establishment of a cerebral hernia as a decompressivemeasure for inaccessible brain tumours. (Harvey Gushing.) Fig. 73.—Male, aged 32, one month after decompressive operation over leftoccipital lobe. Fig. 74.—Size and condition of hernia one year after the first operation. Fig. 75.—Drawing of section of brain which passed nearly through the centreof the tumour, which was a glioma. Note the deflection of the ventricle towardthe hernia. The tumour occupied in large part the entire site of the occipital lobe. Fig. 76.—Sketch of the field of operation before opening the dura, in the sub-occipital procedure. Note the high transverse cut of the crossbow incision. 172 SOME POINTS IN THE SURGERY The patient (Figs. 73, 74, 75) had suffered from headache for two years. Onadmission to hospital the headache was very severe, with mental dulness, intensedouble optic neuritis, projectile vomiting, tenderness over left occipital region, andsome we

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