Some disorders of the cerebral circulation and their clinical manifestations / by Alfred E. Russell.

  • Russell, Alfred E. (Alfred Ernest), 1870-1944.
Date:
1909
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Licence: In copyright

Credit: Some disorders of the cerebral circulation and their clinical manifestations / by Alfred E. Russell. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    I lO a procedure which, by means of allowing some of the fluid to escape, diminishes the pressure within the cerebro-spinal space. Numerous cases of urjemia were quoted from the literature in which marked relief had followed on the lowering of intra-cranial tension by means of removal of cerebro-spinal fluid by lumbar puncture. I will only quote here Willson’s cases as a type. In two papers he records ten cases.* Of the ten cases, six had convulsive movements, general in five and unilateral in one. In every case the convulsions terminated on the withdrawal of the cerebro-spinal fluid, and in only one did they return within several weeks of the operation. His best results were obtained in those cases in which the fluid spurted from the cannula, i. e. in which the pressure was greatest. In the autopsies of fatal cases (three out of the ten) increased cerebro-spinal fluid, dilated ventricles, and oedema of the brain were found. A sufficient number of cases were quoted to show that marked relief may follow lumbar puncture in cases of uraemia. It is well known that ureemic convulsions and coma may disappear apart from such treatment, but the promptitude with which the improvement occurred was such * Willson, “ The Pathogenesis of Uraemia and Eclamp- sia,” 'Journ. of Amer. Med. Assoc.,’ 1904, p. 1019; also “The Relief of Uraemic Hemiplegia and other Uraemic States by Lowering Intra-cranial Pressure,” ‘Transactions of College of Physicians of Philadelphia,’ 1905, xxvii, P- 34-