Stewart, T. G.

2019-02-15T14:23:32Z

2019-02-15T14:23:32Z

1912

The subject of this Thesis is Compression Paraple -, gia, a term which I use in the generally accepted sense of all those conditions in which there is pressure upon the cord, whether a true motor paraplegia in the narrower sense of the word, that is paralysis of the lower limbs, is present or not.

The subject therefor; includes such conditions as spinal tumour, morbid conditions of the lepto- and pachymeninges, spinal caries, malignant disease of the spine and so on. It should also have embraced injuries to the spinal column, but I have excluded the consideration of traumatic paraplegia, my desire being to study more especially the more chronic forms of the condition.

I have devoted particular attention to certain of these conditions, dealing only briefly with others, such as spina/ caries, since to have discussed these exhaustively would have led me into details of medicine and surgery outside the scope of neurology.

PART I. I have divided the essay into two main divisions. In the first :I have endeavoured to correlate the signs and symptoms of the condition with the anatomy and physiology of the structures involved. It has been necessary to deal only quite briefly with the general anatomy of the spinal cord and the canal in which it lies and with the tracts and nerves concerned with motor functions. The sensory functions,however, demand somewhat fuller consideration. During the last few years a large. - mount of valuable work has been accomplished, notably by Head, well nigh revolutionising our conceptions of the subject.

My own observations on compression paraplegia are fundamentally in accord with the main lines of modern research. I have therefore explained somewhat fully the grouping of the various sensory impulses in so far as they are concerned with the disorders under review, more especially the remarkable change which occurs in the cord as compared with the peripheral nervous system.

The principle symptoms and signs of compression paraplegia are associated with the spinal roots,the cord itself and the spine. These symptoms are next discussed seriatim. In as much, however, as the involvement of these structures both in point of time and distribution varies remarkably according to the particular nature and site of the lesion. a spinal tumour, for instance, differing in its nature from that of a meningeal or vertebral affection - I have considered it advisable to deal with the symptoms from this point of view in a short section.

To complete the symptomatology of the condition there remains yet to be described certain general symptoms such ae alterations iii the respiratory, cardiac and vasomotor systems and the consideration of the effect of the level of the lesion upon the symptomatology of any individual case. These are dealt with in a short chapter in which I have included the motor and sensory localisation of the spinal cord.

PART II. In the second part I have considered more in detail the various extra -medullary disorders with which compression paraplegia may be associated.

For this purpose I have collected and analysed a series of cases of compression paraplegia to Which I have added cases w} :.ch clinically simulated. compression paraplegia but which operation or post mortem examination proved to be due to other causes.

http://hdl.handle.net/1842/34107

The University of Edinburgh

Annexe Thesis Digitisation Project 2019 Block 22

Compression paraplegia

Thesis or Dissertation

Doctoral

PhD Doctor of Philosophy