Tumours of the Frontal Lobe.
نویسنده
چکیده
General Considerations The difficulties in diagnosing frontal tumours have been well recognized, not only by all writers on the subject, but by all clinicians whether they have contributed to the written word or not. The reasons for this are not hard to find, and centre chiefly round the fact that large though the frontal lobes are they contain no structure whose destruction must necessarily cause an obvious alteration in the patient, an alteration that could not have been produced by a lesion elsewhere. Objections to this statement come to mind, for it will be remembered that the motor area and the pre-motor area both lie within the frontal lobe. They demarcate, however, its extreme posterior border and it is clear that unless a tumour is so far back in the frontal lobe that it almost ceases to be a pure frontal tumour no disturbance of motion will result. On the left side the so-called motor speech centre, or Broca's area, comes within the anatomist's definition of the frontal lobe, so that difficulties in the exteriorization of speech might well be found with a frontal tumour far enough back to involve these mechanisms. We must not be unduly impressed with the importance of the grey matter of the cortex at the posterior end of the left third frontal convolution. Tumours, and forthat matter other lesions as well, more commonly produce their effects by interference with the white matter, by cutting deep association and projection fibres, than by destruction of the layers of cells in the cortex. It is more probable that defects of speech are due to damage to these deep fibres than to loss of cells with a special function in the cortex. This belief has led in more recent years to speech defects being referred to damage of ' the region of the insula ' (island of Reil), a brain area that belongs as much to the temporal lobe as
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عنوان ژورنال:
- Postgraduate medical journal
دوره 26 293 شماره
صفحات -
تاریخ انتشار 1939