IT has been my misfortune to meet with several cases of meningocele, encephalocele, and hydrencephalocele. Most of them died in the course of few weeks or months; convulsions preceding death. Of the three forms of tumor, hydrencephalocele may be considered the most unfavorable. These tumors consist of brain substance, the meninges, and fluid. Encephalocele consists of cerebral substance only, while a meningocele contains the membranes of the brain. These protrusions have been mistaken for polypi, abscesses, vascular growths, and cephalhaematoma. These tumors have been treated by injection of iodine; “Mr. Annandale ligatured the mass in one instance, and effected a cure.”
Bandages have been employed, muslin caps lined with cotton, and gutta-percha caps filled with wadding, all of these get out of place easily; they have to be reapplied frequently, and besides, they do not afford the child’s head any protection. From the moment these protrusions appear, they are constantly, and besides, they do not afford the child’s head any protection. From the moment these protrusions appear, they are constantly in the way, and as constantly being bruised or injured in some way. If the child is lifted up, or laid down, the diseased part is almost certain to receive injury, and thus retard any disposition towards recovery.
After some very disappointing experience, I adopted the following treatment: Immediately, on the discovery of a case of cerebral protrusion, I paint the protruding part with collodion; I order the nurse to do this three times a day. The collodion is carried entirely over the tumor, and down upon the scalp one-half an inch below the lower line of the protrusion. In twenty-four hours the hardened collodion has made a light, strong, cartilaginous-like cap, which fits loosely, yet perfectly, the protruding cerebral substance. From the moment it is applied the child is protected from all ordinary chances of head injury.
Its head can be washed, its hair brushed, and it can be laid upon its pillow with but little chance of injuring the diseased parts. If the tumor protrudes much, it raises the plate, and yet is still covered by it. At the expiration of a week or so, I only paint the upper half of the plate and scalp, having the lower half free to permit of spraying or syringing with carbolized water. This is done three times a day. I have prescribed Belladonna and Calcarea phosphorica, as indicated. I have just dismissed a case of this kind, the treatment of which was very satisfactory.
The opening closed gradually, new matter being deposited, until at this date not a trace of disease can be seen, and the child is, to all appearances, mentally and physically well. Dr. S.B. Parsons saw this case with me, and at his suggestion I prescribed Calcarea phosphorica, and this, I believe, hastened the cure. I present this paper for your consideration, because the management of this class of cases is usually difficult and very unsatisfactory; while the formation of a protective cap with collodion is original with me, as far as I am able to learn in looking over the literature of this subject.