The more marked the alterations in pulse and respiration the more likely is the tumour to be subtentorial in position.
Alterations in temperature.
The temperature tends to remain subnormal throughout the progress of the case, except during the terminal stages when pyrexia is often observed. Occasional elevations of temperature during the course of the illness may be explained by transient attacks of ependymitis or cerebritis.
Differences of temperature on the two sides of the body may occasionally be observed, especially when the tumour involves the basal ganglia.
II. Localizing Symptoms
(A) To the non-excito-motor frontal region (anterior frontal).
Headache tends to be localized to the frontal region, vomiting is seldom a conspicuous feature, and optic neuritis is not only rather later in development, but also less progressive than when the tumour is placed in other situations. If the tumour occupies the orbital aspect of the lobe, primary optic atrophy (from pressure) may be existent on the affected side with optic neuritis of the contralateral fundus.
The mental condition is often profoundly altered and, according to some writers, more especially so when the tumour is situated on the left side. The quality of mental change varies considerably in individual cases. In some there is an attitude of general suspicion, the patient following all points in his general examination with a curious air of suspicion, in others moral perversion is the rule, whilst in a third group of cases a state of elation and exhilaration is the predominant feature, a condition which, as previously stated, is said to be pathognomonic of a tumour frontally situated.
Anosmia—uni- or bi-lateral—may be present, but, on account of the general condition of the patient, considerable difficulty is experienced in endeavouring to demonstrate the existence of this symptom.
