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

PATHOLOGY OF NERVE LESIONS. 69
consequences which may follow acute inflammation I
have not seen in man, so as to be able to relate them clinically.
Rokitansky has stated them concisely. The nerve,
is dotted with minute extrava-
intensely injected in lines,
sations of blood, becomes oederaatous, and at last firm,
from a grayish or yellowish-red gelatinous fluid, which
hardens soon or late, at the same time that the surrounding
tissues become involved, and present the ordinary
inflammatory appearances. Should resolution occur,
these products are slowly reabsorbed, and a gradual return
of function takes place. Higher grades of neuritis
reduce the nerve rapidly- to a gray or yellowish-red pulpy
cord, for which the inflammation and the constricting
sheath are together responsible. The nerve is then tender,
and readily torn, and its tissue infiltrated with bloody pus,
the color of the nerve becoming yellow or brownish-red
or chocolate tinted, while abscesses may form around its
track. Ulceration is described as the final stage of this
destructive process.
When the more acute inflammations pass into those of
a lower grade, or when these alone have attacked a nerve,
a series of changes result with which I am personally
more familiar.
The nerve trunk is then more irregularly vascular, and
is enlarged in some places and smaller than it should be
in others. The induration, which aflects more or less the
whole of the inflamed portions, varies in density, so that
sometimes there is a long, firm swelling of an inch or more
of nerve, or else in a part moderately hard there is a succession
ot firm little fibroid bodies imbedded, and around
them a circle of greater vascularity than elsewhere. The
color of the nerve is usually some tint of gray or pale lead
color, and in all probability the tact corpuscles undergo
enlarsrement and deo-eneration. The tendencv of these
cases is usually towards hypertrophy and hardening of the