Apoplexy and Softening of the Brain. 87 



optic thalamus, the corpora quadrigemini, the fornix. In other 

 cases the crus cerebri, pons, medulla oblongata, corpus calosum. 

 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 considerable flattening 

 of the brain substance. 



When capillary haemorrhages are present— the size of a millet 

 seed or a pea — Friedberger and Frbhner 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, in- 

 volving 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, brownish yellow, yellow, and may 

 become fibrous forming a distinct cicatrix, with loss of brain sub- 

 stance. In connection with the partial absorption of the effused 

 blood, cavities 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 symptoms 

 noticed are a complete loss of consciousness or nearly 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 uni- 

 lateral effusion the 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. Rolling of the eye- 



