DOI: 10.7925/drs1.ucdlib_280621
title: Aneurism at the base of the brain

description: Watercolour medical illustration depicting an aneurism. It has the alternative reference number 1186, P1A and 14 on the front. The Richmond Hospital Museum reference is C.e.15. The entry for this in P263/1 pg. 27 reads 'Aneurism at the base of the Brain. J.s Creen aet 54. Dr Mollan'. The artist's name is in the bottom right corner 'J. Connolly Del.t' and in the bottom left 'Case of J.s Creen Aet 54'. The typescript note under the illustration reads 'Aneurism at the Base of the Brain'. The typescript note on the back begins '2. Multilocular Aneurism at the Base of the Brain'.
description: Scope and content: The full typescript note on the back reads '2. Multilocular Aneurism at the Base of the Brain – Mr R. W. Smith said, the specimens he then produced to the Society were from the body of a man, aet 54, who was admitted in March, 1842, into the Richmond Lunatic Asylum, under the care of Dr Mollan. He had been insane during three year previous. In hospital, his insanity was characterised by great excitability, and disposition to complain, with occasional paroxysms of violent excitement. Six months before his death, he was attacked by spasmodic fits, in which the hands were strongly clenched; they were sometime of an epileptic character. His hearing became gradually impaired, but there was no paralysis. On the 12th of December, 1842, he was found in a state of complete prostration, with respiration very slow, but not stertorous; was delirious, but could reply to questions, although not readily; pulse natural. He died on the 14th, but without having been affected by either coma, stertor, or convulsions. When the skull was opened, there was found considerable turgescence of the vessels of the membranes; the brain itself was of small size and soft. At the base of the brain, towards the left side, was discovered an aneurismal tumour, about the size of a small apple; it occupied the floor of the third ventricle; the tuber cinereum had been destroyed, as well as the origin of the optic, and of the olfactory nerve of that side: the optic nerve of the opposite side was flattened and softened. The aneurism was multilocular; the posterior artery of the cerebrum was traced into the sac; it had, perhaps, originated in a branch of the basilar artery. The middle artery of the cerebrum opened into the aneurism; a similar circumstance had been described by Serres, who had recorded two cases of aneurism within the cranium, one of the basilar artery, the other of the communicating artery. There was also a case by Cruveilhier, and Mr Smith himself on a former occasion had communicated another case to the Pathological Society. The symptoms during life in such cases are very obscure, and it is yet impossible to diagnose what may be the compressing force within the skull, whose existence is indicated by the symptoms. It is remarkable that in all the cases yet observed, there has been deafness, a symptom unexplained by the pathological phenomena. These tumours are, however, of slow growth, and all contain laminated coagula; their structure shows that they are true aneurisms, and they produce death, either by rupture and extravasation, or by disorganisation of the cerebral substance by their pressure'.
description: Numbering/sequence: Original reference number: 1186.