Physiological Salt Solutions for Brain Surgery

Studies of Local pH and Pial Vessel Reactions to Buffered and Unbuffered Isotonic Solutions

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It is common experience that simple exposure of the pia-arachnoid surface of the cerebral cortex during prolonged neurosurgical procedures, such as for an exploratory craniotomy, results in the formation of adhesions between the dura and arachnoid. In certain cases there may be transitory aphasia or paresis during the first week following a simple exploratory procedure. These transitory postoperative complications are usually attributed to “edema.” This explanation has received support in the experiments of Prados, Strowger, and Feindel,15,16 who demonstrated that marked edema does develop following simple exposure of the cortex in cats and that it

Article Information

Aided by grants from the National Research Council of Canada.

© AANS, except where prohibited by US copyright law.

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Figures

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    Tank for holding sterile fluid in constant temperature bath.

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    Sterilizable apparatus for keeping sterile fluid at constant temperature, (a) Stainless steel heating element, (b) Bimetal thermoregulator. (c) Stainless steel sheath for thermoregulator.

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    Irrigation chamber.

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    Effect of contact with the brain surface on the pH of various solutions.

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    Photomicrographs of the pial vessels of a cat brain, (a) under Solution A (unbuffered), (b), under Solution B (bicarbonate-buffered).

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    Effect of pH of the irrigating fluid on the pH of the cortex. The glass electrode recording the pH of the experimental cortex was placed against the brain surface in the perfusion chamber. The electrode recording the pH of the fluid was in the same chamber but its tip was about 1 mm. above the brain. The control cortex electrode was placed against the brain surface in another chamber on the opposite side. The control chamber was filled with Solution B nearly an hour before the record was started and this solution remained there throughout so that it was presumably in equilibrium with the tissue fluids.

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