Injuries of nerves and their consequences - Reflex Sympathetic ...

PATHOLOGY OF NERVE LESIONS. 63
same side, and slight stiffness with severe pain in the
muscles at the back of the neck. In one of my cases
there was a distinct band of red overlying the nerve and
running upward from the elbow, the site of the wound,
into the axilla. In the remainder this symptom was absent.
Two cases had been carefully examined beforehand
without finding any notable tenderness ;
but in these as
in the others, not only was the nerve tender on deep
pressure or on rolling it, but the skin above its track
was sore, and during the second or third day the whole
limb was hyperaesthetic while in two at least the sense of
;
touch, already impaired, was notably diminished in acuteness
by the attack.
In only one was there sudden and marked oedema
within three days, and this case presented, a week later,
one of the best examples of neural arthritis I have ever
met with.
Terminations.— Cases of acute neuritis are said sometimes
to terminate early in resolution, without mischief to the
nerve ;
but in no case within my experience has this happened.
Usually the inflammation lessens, the fever subsides,
and the pain diminishes, but does not altogether
disappear.
At last we have the nerve passing into a state
of subacute inflammation, which may last for months, or
not, as it is well or ill treated.
The following histories may serve better to illustrate
the clinical features of acute neuritis than any more
methodical details :
Case 1.— Dubreuilh* relates a very clear case which followed
upon the excision of a tumor overlying the brachial
plexus. The mass was adherent to these parts, and consisted
of a sac full of hydatids and serum, which were removed,
and then the mass dissected out. The usual
* Nevrite, p. 104.