Differential Diagnosis Between Cerebral and Cerebellar Degeneration and Brain Tumor

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The clinical picture of a brain tumor and a degenerative process in the brain is often similar, and the manifestations of these two pathologic states which progress slowly or intermittently make a differential diagnosis difficult.

During the last eight years at the Neurological Institute of New York, at the University Hospital of Baltimore, and the Cleveland Clinic a relatively large number of patients have been seen who were suspected of having a brain tumor but were shown to have atrophic disease of the brain by pneumo-encephalography or craniotomy. Fifty-two of these cases of cerebral and cerebellar atrophy were selected for a study to determine possible differences in the signs and symptoms of brain tumor and brain atrophy.

In these selected cases the average age was 33 with the youngest 17 and the oldest 47. In all cases hypertension, arteriosclerosis, toxic factors, trauma, and birth injury were ruled out as well as possible by detailed histories and examinations. The patients did not fit into the clinical picture of Pick’s disease, Alzheimer’s disease, or other clearly defined brain atrophies. There have been reported, however, cases of pseudo-sclerosis and of multiple sclerosis which clinically had certain resemblances to the patients in our series.

The average duration of symptoms before pneumo-encephalography or craniotomy was two and one-quarter years. The course of the disease in the great majority of the patients was slowly progressive, but there were several instances of fluctuation or an apparent arrest or improvement in the signs and symptoms. Many of the. . .



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