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The Lucite Calvarium—A Method for Direct Observation of the Brain

I. The Surgical and Lucite Processing Techniques

C. Hunter Shelden, Robert H. Pudenz, Joseph S. Restarski and Winchell McK. Craig

INTRODUCTION O bservations of the living brain through a cranial window have been periodically reported since Ravina described his original procedure in 1811. 5 With the passage of time improvements in the design of these windows have been instituted according to the nature and duration of the proposed experiments. In the earlier investigations windows were usually devised for temporary emplacement into skull openings. More recently, workers have directed their efforts toward the development of more permanent windows. In this communication a technique is

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James C. White and Robert W. Gentry

parietal pleura and the sides of the vertebral bodies. It must therefore be injected within very close proximity to the ganglia in order to be present in sufficient concentration to ensure their destruction. Three years ago one of us (White, 1940) described an improved technique for placing needles against the sides of the upper four thoracic vertebrae for chemical blocking of the thoracic cardiac nerves, † the sympathetic ganglia, and the white rami communicantes. These structures carry afferent impulses from the heart to the corresponding spinal nerves and from

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Gilbert Horrax

himself made the following statement, “In fact, the advance in technique of the surgical treatment of diseases of the brain and the spinal cord has been relatively less than the improvement in our knowledge of the seat and nature of the diseases for which surgical intervention is useful and necessary.” If this was true of Horsley's own work, it was even more so of the leading surgeons in Europe, notably Bergmann, Kocher, Krause, von Eiselsberg, Chipault, Broca and others, all of whom had made signal contributions and had written extensively on the subject of cranial and

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The Use of Products Prepared from Human Fibrinogen and Human Thrombin in Neurosurgery

Fibrin Foams as Hemostatic Agents; Fibrin Films in Repair of Dural Defects and in Prevention of Meningocerebral Adhesions

Franc D. Ingraham and Orville T. Bailey

INTRODUCTION D uring the past forty years neurosurgical operations have developed from hazardous and rarely successful tours de force to well standardized and relatively safe procedures. Many of the major contributions to this rapid development are due to the investigations and teaching of Harvey Cushing. By adapting techniques of general surgery to the particular requirements of the neurosurgeon and by the development of new techniques to meet problems not encountered in other fields of surgery his work was a definitive influence in modern }neurosurgery

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of the country and indeed, by much of the rest of the world. For his was a universal kind of greatness that caused him to be claimed by every human being everywhere. And his kind of contribution was such that it is not limited by considerations of time but belongs to the ages. New techniques and ideas were developed by him which will for centuries to come serve as a foundation for the structure of continuing progress in the delicate and difficult field of medicine to which he devoted his life and genius. This fine hospital will be a fitting monument to him. It

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W. M. Craig

out in the rehabilitation of radial nerve injuries that the patient who has a tendon transplant in conjunction with the peripheral nerve repair can return to duty much earlier and there is no time lost waiting for the nerve to regenerate. While tendon transplant for paralysis of muscles supplied by the median nerve is usually contra-indicated, Bunnell has described such a technique. The extensor carpi-radialis longus is transplanted from the extensor surface of the wrist into the flexor pollicis longus tendon. The profundus tendons to the index and middle fingers

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R. Glen Spurling

applied to all cases after end-to-end suture because the contiguous joints must be kept flexed to shorten the course of the nerve. Such casts are bivalved 24 to 48 hours after operation, or, in some instances, are applied and bivalved preoperatively. Immobilization of the joints is maintained strictly for 2 weeks, although gentle massage and heat are applied after the wound is healed, usually on the tenth postoperative day. Gradual extension of the joints is started after the second week, and full extension is completed by the fifth week. The Technique of End

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A. Earl Walker, Jerry J. Kollros and Theodore J. Case

of which probably represents excitation of the sympathetic fibers which are associated with the vagus nerve in the cat. A 60 cycle per second sine wave has been superimposed upon the sciatic tracing to act as a time record. The record to the right (D) was obtained by concussing the dead cat, other conditions remaining as previously. The discharge is probably larger near the site of the blow, but since our experimental technique may not allow the same physical state at the site of the blow as at other parts of the brain (movement of the dura is a possible

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Colonel C. G. de Gutiérrez-Mahoney

right hand this was excised by subpial resection. The piece of cortex ( Fig. 2 ) removed measured 15 by 10 by 8 mm. There was an immediate disappearance of the phantom fingers and the pain which have not recurred two years after the operation. Fig. 2. Microphotograph of the section of post-central cortex removed at operation. Nissl technique (×16). Thus from analysis of the clinical experiments offered by surgical therapy the unmistakable conclusion is reached that stimuli originate at the periphery in the stump with its amputated nerves which

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of gram-positive cocci. The cellular components of the abscess wall showed nothing remarkable. Comment . In the first of these three fatal cases penicillin was applied too late to control the effects of the pneumococcal infection. In the second case infection was never severe, and death was due to intracranial haemorrhage. The third patient died as a result of an error of surgical technique. If adequate drainage had been provided for the gram-negative pus he would almost certainly have survived, for his other wounds, including the compound fracture of the femur