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J. Grafton Love

with real danger. I have seen one patient who had an arteriovenous fistula (aorta to inferior vena cava) following removal elsewhere of a protruded intervertebral disk. I have been told of another patient who went into a state of shock and died following removal of a protruded intervertebral disk. When postmortem examination was made, a perforation of the abdominal aorta, with fatal hemorrhage, was discovered. Removal of intraspinal neoplasms requires the sacrifice of one or more laminae, and usually (except in the cervical region of the spinal column) one or more

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Intracranial Angiography

I. The Diagnosis of Vascular Lesions

Carl F. List and Fred J. Hodges

is used at 20 MA and 75 KV; for anteroposterior projection, exposure time is increased to 3 seconds and kilovoltage to 85. OBSERVATIONS Thirty-five cases of vascular intracranial lesions have been studied by this method. Our observations will be divided into the following groups: (1) Vascular occlusions and coarctation (2) Intracranial aneurysms (3) Arteriovenous fistulas (4) Congenital arteriovenous malformations 1. VASCULAR OCCLUSIONS AND COARCTATION In massive vascular lesions of the brain, angiography is an

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J. G. Chusid and C. G. de Gutiérrez-Mahoney

to the preoperative control records. CONCLUSIONS 1. In a patient on whom ligation of the internal carotid artery for an intracranial arteriovenous fistula was performed without clinical postoperative complications electroencephalography disclosed relatively minor, transient changes. 2. The final value of electroencephalography as an aid in evaluating cerebral collateral circulation in ligation of the carotid arteries must await further reports and study especially of those instances where complications such as hemiplegia arise

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Arthur Ecker and Richard H. Chamberlain

of the needle in certain patients, and a possible disadvantage to working so close to other structures, such as the extension of the subarachnoid space, cranial nerves, and Eustachian tube communicating with the middle ear. There is also the remote possibility of production of arteriovenous fistula between the internal carotid artery and internal jugular vein. When one is seeking information concerning a possible meningioma which may have a double arterial blood supply; namely, one circulation from the internal carotid and one from the external carotid, it may be

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W. H. Sweet and H. S. Bennett

. We should point out that none of our patients had a carotid cavernous arteriovenous fistula. In this type of case, as suggested by Adson, 22 ligation of the internal jugular vein might have greater likelihood of exerting some measurable delaying action on the venous return. PRESSURE MEASUREMENTS UPON BILATERAL CAROTID OCCLUSION AND THEIR CLINICAL SIGNIFICANCE In several of our cases, while we were recording internal carotid pressures with the ipsilateral common and external carotid vessels occluded in an open wound, we then pressed in the region of the

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Henry A. Shenkin, Eugene B. Spitz, Francis C. Grant and Seymour S. Kety

expected to cause changes in the systemic circulation. Gibbs, Lennox, and Gibbs 2 in 1945 suggested that a low arteriovenous oxygen difference in the cerebral circulation might indicate the presence of an intracranial arteriovenous fistula. Logan, Ferris, Engel, and Evans 5 in 1947 demonstrated that in a case of a large intracranial arteriovenous anomaly there was an increase in the oxygen saturation of the internal jugular blood and hyperventilation increased it to almost arterial levels. This procedure was suggested as an aid in the diagnosis of vascular intracranial

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Rupert Raney, Aidan A. Raney and J. M. Sanchez-Perez

persistent left 6th nerve palsy and a bruit was heard over the left fronto-orbital region, loudest over the orbit. On May 20, 1948, serial angiography was done, which showed an arteriovenous fistula involving the carotid artery and cavernous sinus on the left side. No dye entered the general cerebral circulation; all dye left the cranial cavity in less than 3 seconds ( Fig. 4 ). Fig. 4. Case 3. Note that all blood is out of cranial cavity in Film 3. The short time for passage of blood is due to short-cut lesions. On June 2, 1948, the left common carotid

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Carotid-internal Jugular Anastomosis in the Rhesus Monkey

Angiographic and Gasometric Studies

E. S. Gurdjian, J. E. Webster and F. A. Martin

determinations in acute experiments. The lowered oxygen values in the sagittal sinus occurred in the presence of elevation of oxygen content of the neck veins, thus confirming the angiographic patterns. REFERENCES 1. Beck , C. S. , McKhann , C. F. , and Belnap , W. D. Revascularization of the brain through establishment of a cervical arteriovenous fistula. Effects in children with mental retardation and convulsive disorders. J. Pediat. , 1949 , 35 : 317 – 329 . Beck , C. S., Mckhann , C. F., and Belnap , W. D

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Harold C. Voris

Lesions for which 40 ligations of the internal carotid artery were performed Non-fistulous Aneurysm Arteriovenous Fistula Miscellaneous Total No complications 19 2 3 24 Temporary complications 2 0 0 2 Permanent complications 6 0 1 7 Death 6 1 0 7  Total 33 3 4 40 As shown in Table 2 , death occurred in 7 cases (17 per cent). Three of these deaths were in patients over 50 years of age (total 5). The mortality for patients under 50 years of age was 11 per

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Bronson S. Ray, Howard S. Dunbar and Charles T. Dotter

the pyogenic and neoplastic metastases that heretofore were considered paradoxical. Gius and Grier 9 have recently reintroduced the problems of adaptation of the veins of the brain and head following resection of the jugular veins in the course of radical operations for neoplasms of the head and neck. Beck, 2 in introducing a new operation for improving the blood supply to the brain by the formation of an arteriovenous fistula between the carotid artery and internal jugular vein has posed many new problems pertaining to the anatomy and dynamics of blood flow in