Apoplexy and Softening of the Brahi. 87 



optic thalamus, the corpora quadrigemini, the fornix. In 

 other cases the cms cerebri, pons, medulla oblongata, corpus 

 caiosum. In other cases the convolutions of the cerebrum or 

 cerebellum suffer. The amount of effusion may be limited to 

 a few drops or it may cover an extensive area and cause con- 

 siderable flattening of the brain substance. 



When capillary hsemprrhages are present — the size of a 

 millet seed or a pea^Friedberger and Frohner have usually 

 found them multiple, but when large enough to form distinct 

 clots they are usually single and confined to one side. If a clot, 

 involving the brain substance, is small, it merely separates the 

 nervous fibres, but if larger, the cerebral tissue is broken down 

 in the mass of clot, discolored, torn and .softened. If the 

 patient has survived the first attack the clot passes through 

 the different stages of discoloration, brown, browni.sh yellow, 

 yellow, and may become fibrous forming a distinct cicatrix, 

 with loss of brain substance. In connection with the partial 

 absorption of the effused blood, cavaties may be filled with 

 a serous fluid (apoplectic cysts), and these may show multiple 

 loculi. The nerve fibres which lead to an old standing lesion 

 are usually degenerated. 



When effused into a ventricle, blood is less readily absorbed 

 and tends to remain as a flattened discolored layer. 



Extravasation between the dura mater and the cranium is 

 probably always the result of direct mechanical violence. 



Symptoms. Premonitory indications of apoplexy are less com- 

 monly recognized in the lower animals than in man, doubtless 

 largely because of the impossibility of appreciating subjective 

 symptoms. The first observed indications are usually dullness, 

 some lack of coordination of movement, swaying, unsteady 

 gait, trembling and a tendency to deviate to one side or to 

 move in a circle. In the majority of cases, however, the first symp- 

 toms noticed are a complete loss of consciousness or nearh' so, a 

 sudden fall and often more or less convulsive movements of 

 the limbs aggravated by any excitement. The eyes remain 

 dilated, the pupils enlarged or sometimes contracted, and in case 

 of unilateral effusion tlie axis of vision of both eyes is turned 

 to the affected side, right or left. The pupil of one eye is 

 likely to be more widely dilated than that of the other. Roll- 



