CASE HISTORY

Admitted 8.12.37 with severe headache, staggering gait, squint and personality changes. These symptoms started 2 months ago. His left arm was drawn up, left fingers claw like and spastic. There was involvement of 5th and 6th and 7th cranial nerves. Cerebrospinal fluid showed 160 cells per cm3, 71% polymorphs, and 26% lymphocytes. Latterly cerebrospinal pressure rose to 200mms and papilloedena became marked during last few days. The diagnosis lay between tuberculoma, encephalitis and tumour of brain. 9.1.38 Died.

PATHOLOGY

There is a large bulging tumour of the pons (about the size and shape of a hens egg) which causes great distortion of the structures at the base of the brain. Tumour growth has invaded through the leptomeninges on the ventral surface of the pons. An area of haemorrhagic softening in the tumour extends out to the ventral surface and this is the probable source of the cells in the spinal fluid. The aquaduct is compressed and the ventricles dilated.