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Milton Brougham, A. Price Heusner and Raymond D. Adams

amount of freshly clotted blood covered the posterior margin of the mass and occupied the adjacent subarachnoid spaces. There were small amounts of blood in the lateral and 3rd ventricles. Except for slight atherosclerosis of the large cerebral arteries, there was no other gross abnormality of the brain or of the other organs. On microscopic examination large portions of the intrasellar tissue were seen to be necrotic and infiltrated with neutrophilic leucocytes. In the better preserved parts the cells were very close together and without special arrangement

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George Margolis, Guy L. Odom, Barnes Woodhall and Byron M. Bloor

absence of evidence of kidney disease, hypertension, or significant atherosclerosis. In the left cerebral hemisphere a hematoma, 4 cm. in each dimension, occupied the frontal lobe anterior to the basal ganglia ( Fig. 4A ). It approached the anterior tip of the lateral ventricle, but the ventricles and subarachnoid space were free of gross bleeding. At the ragged medial margin of the hemorrhage a venous angioma was observed ( Fig. 4A ). This consisted of a network of small, thick-walled vessels, distributed sparsely within the otherwise normal parenchyma. The lesion was

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Kenneth H. Abbott, James R. Gay and Robert J. Goodall

revealed a grade I platybasia.) Delayed ( 30 minutes ) loss of consciousness, sudden respiratory failure and death occurring in 2 cases of atherosclerosis and thrombosis of the internal carotid with cerebral infarction . Case 2 . A 53-year-old white male was studied because of progressive left hemiparesis. Difficulties were encountered in doing carotid angiography by the percutaneous method and therefore the open method was used. It was recognized that the right carotid appeared firmer than usual but the needle was inserted into it anyway. Blood flowed only fairly

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Eldridge Campbell, Dogan Perese and Nolton H. Bigelow

ovoid structure was composed of a relatively thin grey-white membrane in which foci of calcification, evident atherosclerosis, were present. Projecting outward from the primary sac were two secondary or daughter aneurysms, which measured 2×1×1 cm. and 1.5×1×1 cm. respectively. There was also a roughly pyramidal protuberance consisting of a wide-based but pointed tip, measuring 1.5×1×1 cm., which appeared to represent the early development of a third daughter aneurysm. The lumen of the aneurysmal sac contained not only freshly congealed (and formalin-fixed) blood, but

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Peripheral Collateral Circulation Between Cerebral Arteries

A Demonstration by Angiography of the Meningeal Arterial Anastomoses

Harold Rosegay and Keasley Welch

; softening of the inferior cingulate region on the right; (3) atherosclerosis and arteriolar sclerosis of the cerebral vessels. Summary A 33-year-old woman, with essential hypertension, suffered three subarachnoid hemorrhages from an aneurysm of the anterior communicating artery. Since the aneurysm was shown on angiography to fill from the left carotid but not from the right, the left anterior cerebral was clipped proximal and distal to the aneurysm. On postoperative right carotid angiograms occlusion of the right anterior cerebral was seen ( Fig. 5 ), and this was

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Oscar Sugar and Paul C. Bucy

(especially severe in the brain and heart), atherosclerosis of the aorta and its major branches, and right and left ventricular dilatation. In the brain all large vessels showed atherosclerosis. This was especially marked in the vertebral, basilar, and posterior cerebral arteries. Cross-sections of the posterior cerebral and superior cerebellar arteries showed marked narrowing of the lumina (corresponding to the thin column of contrast material in the angiogram). There was no evidence of antemortem thrombosis, at least at the origins of these vessels. There was marked

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Kenneth E. Livingston, Alfonso Escobar and Gregory D. Nichols

follows might be reduced. Our experience leads us to propose that further clinical study of cerebrovascular thrombosis be carried out—first to enlarge our knowledge of the vascular changes associated with the “stroke” syndrome, and ultimately to apply available data in an effort to reduce resulting disabilities. REFERENCES 1. Adlersberg , D. , Schaefer , L. E. , and Wang , C.-I. Adrenal cortex, lipid metabolism, and atherosclerosis: experimental studies in the rabbit. Science , 1954 , 120 : 319 – 320

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John S. Meyer and John Hunter

, lowering the blood pressure to 50 mm. of mercury in the presence of an occluded middle cerebral artery results in severe localized cerebral anoxia and eventually in infarction. 3, 7, 9, 10 The observations recorded in Case 6 ( Fig. 6 ) permit further analysis of this phenomenon. At necropsy an organized thrombus occluded the sigmoid portion of the right internal carotid artery above the foramen lacerum. All vessels of the circle of Willis showed marked atherosclerosis and there was patchy infarct necrosis in the distribution of the right middle cerebral artery. In Fig

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Ira J. Jackson and Stanley M. Fromm

atherosclerosis and none exhibited any canalization that appeared to be functioning. However, they gave no statistical analysis of the surgical results. Three of their patients were treated by reconstruction of the bifurcation after excision of the atheromatous segment and in each re-thrombosis occurred. They merely stressed the clinical picture, the ability to diagnose, and suggested the possibility of treatment by arterial graft. They hoped by excising the thrombosed segment, there would be no further emboli propagating from the thrombus. Therefore, although the literature

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E. H. Botterell, W. M. Lougheed, T. P. Morley and S. L. Vandewater

depth of anaesthesia and small doses (25 mg.) of chlorpromazine are used during the operation and postoperatively as required. In elderly patients, or patients with evidence of atherosclerosis, arteriosclerosis and hypertension, our aim has been to avoid lowering the temperature below 30°C. In younger patients with no apparent cardiovascular disorder, the minimum temperature has commonly ranged between 28.6°C. and 30°C. RESULTS AND COMPLICATIONS ATTRIBUTED TO HYPOTHERMIA Hypothermic anaesthesia has been utilized in 88 cases of cerebral vascular problems