The most important indication of brain tumor is a gradual development of signs pointing to a sharply limited lesion of the brain; this may occur when the general symptoms of tumor, headache, nausea, vomiting and papilledema, are absent. It may, of course, be produced by other lesions, but in none is it so common as in tumor.
It is desirable to call attention in this connection to a symptom-complex that I have treated more at length in a paper read at the last meeting of the American Medical Association, namely, gradually developing hemiplegia. The importance of this complex is frequently overlooked. Since the presentation of the paper referred to I have had the opportunity of observing in consultation another case in which the only important signs of brain tumor had been a hemiplegia of uncertain beginning with hemianesthesia, in which, without any sudden increase of symptoms, the weakness had imperceptibly
SPILLER WG. SYMPTOMATOLOGY AND LOCALIZATION OF OBRAIN TUMOR. JAMA. 1910;LIV(8):579–588. doi:10.1001/jama.1910.92550340001001
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