TUMORS OF THE BRAIN.
Symptoms.—The symptoms of a tumor of the brain vary according to the size of the growth, its location, the rapidity of its development, the age of the pa tient, the character of the tumor, and the indirect effects on distant portions of the brain. These may be classed as general and focal. Usually the former are the first to attract the attention of the patient, but occasionally the mani festations of the latter are the first to cause him to seek the advice of a phy sician. The general symptoms are usu ally headache, intermittent or constant, with periods of exacerbation, going on for weeks or months before dizziness, nausea, and apparently causeless vomit ing are complained of; not infrequently disturbance in vision or a general con vulsion occurs before or soon after the headache has become severe enough to interfere with the comfort of the pa tient. In the cases in which focal symp toms have been the first to appear, con vulsive movements, limited to a group of muscles, to one limb, or to one side of the body, or symptoms of speech-dis turbance lead the patient to seek relief. As the disease advances the early symp toms become more marked, and numer ous others are added, much to the dis comfort and incapacity of the patient.
Headache, if not severe before, soon be comes agonizing; vision gradually or rapidly lessens; vomiting often occurs with or without nausea, especially in early morning, when the lesion is situ ated in the posterior fossa or at the base of the brain, and the patient may be come greatly emaciated; sustained men tal effort is impossible, both on account of the headache which it usually aug ments and on account of the mental de terioration resulting from brain-disturb ance; walking may become difficult or impossible, either from paralysis or from interference with muscular co-ordination, the latter usually being due to a growth in the posterior cerebral fossa, the cere bellum, or in the region of the corpora quadrigemina; there may be disturb ances of special and general sensory phe nomena. Various respiratory and cir culatory irregularities may be present. Usually the patient becomes stuporous and finally comatose before death takes place. In a few cases convulsions cause death before the patient dies from ex haustion.
Among the general symptoms, head ache. double optic neuritis (choked disk), vomiting, vertigo, and general convul sions are the most important.