630 



Hcinoniiaiic of the Brain. 



cause sudden death, (llolterbacli observed uninterrupted rumi- 

 nation in a cow that was otherwise quite unconscious owing to 

 intenneningeal and intraventricular hemorrhage.) 



Judging from the scanty records of the published cases the 

 local symptoms would appear to resemble those seen in con- 

 tusion of the brain (see page 625). 



Diagnosis. The sudden occurrence of symptoms of loss of 

 consciousness without any traumatic influence at work and under 

 conditions which suggest the possibility or probability of hemor- 

 rhage of the brain, 

 indicates that such 

 h e m o r r h age has 

 taken place either in 

 the brain itself or 

 between its mem- 

 branes. Hemorrhage 

 may occur in cases 

 of encephalitis but 

 in cases of this kind 

 the loss of conscious- 

 ness is preceded by 

 some evidence of ill- 

 ness and often by a 

 rise of temperature. 

 The rise of tem- 

 perature is often ob- 

 served after the 

 hemorrhage has oc- 

 curred. Embolism 

 may lead to similar 

 sjanptoms and this 

 possibility must al- 

 ways be borne in 

 mind in cases in 

 which there is or- 

 ganic disease of the 

 heart, thrombosis of the anterior aorta or vessels of the head. 

 Sudden collapse may be caused by anemia or edema of the lungs, 

 but in such cases the difficulty of respiration is a prominent 

 symptom. Differential diagnosis is less difficult in cases where 

 collapse is due to heart disease because there is little or no dis- 

 turbance of consciousness. 



As a rule the position of the hemorrnage can only be ascer- 

 tained by observing the local symptoms during the later stages 

 of the disease. 



In herbivora a microscopic examination of the blood is in- 

 dicated in view of the fact that the case may be one of anthrax. 



Treatment. As in all cases of hemorrhage rest is of prime 

 importance. Immediately or within a short time after the 



Bilateral epidural hemorrhage 



