Syringomyelia.

  • Hinsdale, Guy, 1850-
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Syringomyelia. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

    18/90 (page 8)
    developmental irregularity in the distribution of cellular elements; that, furthermore, the filling up of congenital or acquired spaces in the neuroglial* element with the products of some new formation, glioma for example, and the exercise of pressure from within outward, will react upon the gray matter, so that as it degenerates the intrinsic symptoms of the disease pre- sent themselves, and as later the white matter itself undergoes transforma- tion, the extrinsic symptoms are added to the list. Pathology.—On examining the cord as it lies in the vertebral canal the general appearance may be entirely normal. The meninges are apparently healthy, but upon opening the dura mater, if the case be well marked, the cord will bear a strong resemblance to a large blood-vessel filled with a moderate quantity of fluid, having walls reduced in thickness in proportion as the gray matter has been destroyed. On pressure it is found to lack resistance, being soft and fluctuating. In extreme cases it may be of ribbon-like appearance. The cervical enlargement is relatively great, or at whatever locality a glioma may be present there may be a fusiform swelling. The cervical and upper dorsal regions are the usual seats of the affection. The external appearance is not always so characteristic in cases of moderate degree. On cross-section the distinctive features of the disease are apparent to the naked eye. In successive sections of a well-marked specimen we may trace the glioma and its cavity throughout its vertical extent. Fig. 6.1 %-.■■ . Syringomyelia.—Upper cervical region. Here the cavity extends far across the cord, almost sym- metrically on either side. The gliomatous formation extends out along the posterior horns, almost cutting off the posterior columns from the rest of the cord. The lateral tracts are much degenerated, especially the right, and the right direct pyramidal tract. Remnants of the anterior horns can be made out as narrow projections in front of the cavity (the left alone is shown in the drawing -; they contain only a few multipolar cells degenerated. The anterior parts, especially, of the posterior columns, are degenerated. But little trace of posterior root-zone. The gliomatous tissue extends almost entirely around the cavity as a rim or circle. The cavity is usually single, but there may be several cavities inde- pendent of each other or intercommunicating. The cross-section of the cavity is generally elliptical, or merely a narrow slit with the long diameter 1 The author wishes to express his indebtedness to Dr. James Hendrie Lloyd for the use of these valuable illustrations, which were executed from photographs by Dr. William M. Gray, of the Army Medical Museum, Washington.