THE .... The Committee on Medical Practice and the Plan for the Regulation of Contract Medical Practice-By. J. J. R. Macleod, Cleveland..... Chronic Deforming Arthritis Developing During the Course of a Tuberculous Infection of the Ankle-By George I. Bauman, M. D., Cleveland........ 33 The Action of Caffein on the Mammalian Circulation-By J. D. Pilcher, Department of Therapeutics-Conducted by J. B. McGee, M. D.. Reports of Meetings of the Academy of Medicine of Cleveland.... 13706 JAN 28 1915 LIBRARY The Cleveland Medical Journal VOL. XI JANUARY, 1912 No. 1 The Differential Diagnosis of Conditions Causing Increased Intracranial Pressure. By CARL D. CAMP,. M. D., Clinical Professor of Diseases of the Nervous System in the University of Michigan, Ann Arbor. To some extent variations in the pressure within the intracranial cavity are physiological but just to what degree these variations may exist within physiological limits is still problematical. Ordinarily, we speak of the increased pressure as pathological only when it gives rise to those symptoms or signs which we have, by experience, come to associate with such an increase. In infancy, before the cranial bones are fully ossified or the fontanelles closed, this pressure will give rise to changes in the size and shape of the head, enlargement of the fontanelles, opening of the sutures, etc. In more mature individuals, when this enlargement cannot take place other symptoms commonly develop, such as: headache, vertigo, feeling of fulness in the head, disturbance of consciousness, epileptiform attacks, nausea and vomiting, slowness of the pulse and papillo-edema, or choked disc. At times, in infants, the same symptoms may develop if the rate of increase in pressure is greater than can be overcome by the rate of enlargement of the skull. The symptoms enumerated above occur as the result of the general increase in intracranial pressure but usually give us by themselves, no clue to the cause of the increase; furthermore, by their intensity, they indicate the rate of increase rather than an absolute amount. The difficult problem is to determine what pathological conditions may be responsible for increased intracranial pressure Address before the Section on Mental and Nervous Diseases of the Ohio State Medical Association Meeting at Cleveland, May, 1911. |