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Robert A. Kuhn

both vertebrals and of the basilar system. Neuralgias of the brachial-plexus roots and a transitory Brown-Séquard syndrome are among other unfortunate sequelae 25 which include creation of an arteriovenous fistula between the vertebral vein and artery. Although there are no autopsy data to support the view, it is probable that a very high proportion of serious local damage to the artery accompanies all percutaneous punctures. The lumen of the artery is not much larger than the 18-gauge needle used to penetrate it. Considering the small bore and deep position of the

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William Beecher Scoville

sleeves with nearly complete block at C5 and C6 interspaces, and operation was advised to prevent progression. Bilateral decompressive facetectomy at C5 and C6 interspaces with laminectomy was performed. There was moderate improvement in arms with no change in legs. There was no progression in 2½ years. Case 4 E.B.J., a 56-year-old male, had a pulling injury of the left arm with Erb's paralysis of upper brachial-plexus type; no sensory loss; and no involvement of the posterior columns. Myelography, done to test for avulsion, showed a bonyridge defect at C4 with

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Neuronal Regeneration in the Central Nervous System of Man

Successful Growth of Intercostal-Spinal Nerve Anastomosis and Growth of Intercostal Nerve-Spinal Cord Implant

L. W. Freeman

plexus (Erb's type). Ann. Surg. , 1948 , 127 : 317 – 326 . Lurje , A. Concerning surgical treatment of traumatic injury of the upper division of the brachial plexus (Erb's type). Ann. Surg. , 1948, 127: 317–326. 6. Sperry , R. W. Effect of crossing nerves to antagonistic limb muscles in the monkey. Arch. Neurol. Psychiat., Chicago , 1947 , 58 : 452 – 473 . Sperry , R. W. Effect of crossing nerves to antagonistic limb muscles in the monkey. Arch. Neurol. Psychiat., Chicago , 1947, 58: 452–473. 7

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Donald T. Smith

bronchogenic carcinoma of the right lung with involvement of the right brachial plexus. This patient had expired 1 week following a left high-cervical cordotomy. The ages in this group of patients ranged from 43 to 79 years. However, within the total of 100 patients autopsied, the first eight decades of life were represented. As previously stated, the cystic formations were always in association with the dorsal root and proximal to the dorsal root ganglion. This is in agreement with the observations of Tarlov. 17 Why the ventral root has never been found to be the site of

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W. Eugene Stern

injuries and traumatic apoplexy, and his experimental investigation of the pathogenesis of depressed skull fractures. Peripheral-nerve surgery received his attention from World War I onward and he contributed methods of splinting, techniques of suture and surgical exposure, and a method of reconstruction of the paralyzed swallowing mechanism after injuries of the jugular foramen. The role of the anterior scalene muscle in brachial-plexus compression was emphasized by his writings such that the syndrome now carries his name. Stimulus from surgical practice led to

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Eldon L. Foltz and Lowell E. White Jr.

brachial plexus 2 years previously. His left arm steadily had become more painful with causalgic type of burning dysesthesia, which was precipitated frequently by emotional instability as well as sensory stimulation to the extremity. The extremity showed a partial brachial-plexus lesion and early atrophic changes in the skin with marked vasomotor instability. The Department of Psychiatry had stated his basic personality was such that he required this pain as a “somatic crutch,” and that interruption of such support probably would cause a complete disruption of

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Donald T. Smith

or turning the patient, coughing, or other maneuvers. They do not appear to represent the extradural meningeal diverticulum that has been described in the thoracic region, and from their central location within the spinal canal most certainly have no relation to the spinal-nerve roots or the dorsalroot ganglia. By their gross configuration, the lesions described in this study possibly might be considered related to the lateral outpouchings of the meninges seen in patients with a brachial-plexus avulsion. In this case the absence of a compatible history and lack

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Robert H. Wilkins

paralysis was not permanent. Microscopic examinations of the segments below the level of section did reveal some evidence of scattered descending degeneration; the great majority of degenerations, however, occurred above the area destroyed and extended in the ascending direction. Consequently Schäfer's 9 explanation does not seem to us entirely satisfactory. The experiments of Mott and Sherrington, 10 on the other hand, are most suggestive. They divided the posterior roots of the nerves supplying the brachial plexus in a monkey and found that the arm was as much

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Edir B. Siqueira, Bill G. Karras, Abram H. Cannon and Paul C. Bucy

proximal portion of the vertebral artery. Schechter 20 has described a technique in which the entire vertebral artery is visualized but it requires two injections and appears to be very difficult. In some patients the small caliber of the vertebral artery nearly precludes direct puncture by any approach. Trauma to the neck and irritation of the brachial plexus are frequent occurrences. Other methods for visualizing the vertebral-basilar system that have been described include open retrograde injection of the carotid artery after its surgical exposure. 19 The

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Robert W. Olson, Hillier L. Baker Jr. and Hendrik J. Svien

angiography. In 1946, Elkin and Harris, 1 reviewing their experiences, reported 10 cases, all secondary to trauma. Most of the wounds were caused by a small fragment of highly explosive shell during the second world war. They stated that this injury was rare because of the protected position of these vessels as they course through the neck. The complications that have been reported 3–6 following cutaneous vertebral angiography are varied. Extravasation of media, hematoma, sensitivity to iodine, and injury of the brachial plexus are among the more common. On occasion