Journal of neurosurgery
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In the annual address, the President of the American Association of Neurological Surgeons reviews the responsibilities and the continued dedication of the members of the Society to the goals of excellence in patient care, education, and investigation. Insistence upon first-class standards of training has not waivered despite cynical impugnment of our motivation. Dividends of advantage to the general welfare can come from assistance in the design of enlightened legislation, in the assessment of the scientific basis and therapeutic value of various procedures, and in the support of rigorous training for neurosurgeons, fostering the development of excellent clinicians as well as investigators.
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Thirty cadaver brains were examined under X 6 to 16 magnification in order to define the microsurgical anatomy of the pineal region, particularly the relationship of the pineal body, posterior cerebral artery, superior cerebellar artery, vein of Galen, basal vein of Rosenthal, internal cerebral vein, straight sinus, bridging vein, the size of the tentorial notch, and the third and the fourth cranial nerves. The infratentorial and supratentorial approaches to the pineal region are compared from the viewpoint of microsurgical anatomy.
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Journal of neurosurgery · Jul 1980
Case ReportsElective extracranial-intracranial arterial bypass in the treatment of inoperable giant aneurysms of the internal carotid artery.
Thirteen patients with giant aneurysms of the internal carotid artery (ICA) were treated with ICA ligation and an extracranial-intracranial arterial bypass. A method for establishing a proper superficial temporal artery to middle cerebral artery pressure gradient while maintaining partial flow through the ICA is presented. This procedure allows the anastomosis to become established before full occlusion of the cervical ICA. None of these patients suffered any immediate or delayed ischemic or rebleed complications over an average follow-up period of 18 months.
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Journal of neurosurgery · Jun 1980
Relationship of cerebral blood flow to cardiac output, mean arterial pressure, blood volume, and alpha and beta blockade in cats.
The relationship among cerebral blood flow (CBF), blood volume, cardiac output (CO), and mean arterial blood pressure (MABP) at varying levels of arterial CO2 tensions (PaCO2) were studied in 70 normal cats. The CBF was measured from the clearance curve of xenon-133 and CO with a thermal dilution catheter placed in the pulmonary artery. The CBF, CO, and MABP values varied appropriately with changes in PaCO2, confirming the reliability of the preparations and the presence of normal autoregulatory responses. ⋯ The ability of the brain to resist increases in MABP and CO and maintain normal CBF is explained by normal cerebral autoregulation. However, its vulnerability to modest decreases in blood volume, which cannot be attributed to variations in perfusion pressure, is unexplained but obviously has important therapeutic implications. This may be related to reduction in CO, changes in autonomic activity, or a decrease in the size of the perfused capillary bed.