Isolated cerebral hypothermia by single carotid artery perfusion of extracorporeally cooled blood in baboons.
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Biomedical subjects
Publications and source records attributed to J Verdura.
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Following an historical review of earlier attempts to develop separated head and brain preparations and their contributions to modern-day understanding of the neurophysiology and neurochemistry of the central nervous system, the experiments that eventually led to the first successful total isolation of the mammalian brain are presented. The operative strategies emphasizing the anatomical and physiological problems requiring solution that resulted in vascular and neurogenic separation from the parent body and cephalon are described. The innovative engineering concepts that were utilized in the design of miniaturized equipment to maintain the isolated brain in a living state under conditions of cross circulation, extracorporeal artificial perfusion and transplantation are elaborated. Investigations employing isolated brain and cephalic preparation documenting tissue substrate requirements, metabolic and rheological conditions prevailing at various low temperatures and the immunologically privileged state of the separated organ are briefly presented. The unique opportunities these isolated brain models offer for study are emphasized as well as the complexity of their surgical preparation, which, to date, has limited their universal applications.
Utilizing a technique of selective surface head cooling and naso-oral perfusion, rapid profound cooling of the brain to 14-19 degrees C with maintenance of body temperature has been achieved in 24 dogs. Post perfusion, neurological examination of the animals were within normal limits, and neuropathological review of brain specimens demonstrated absence of tissue abnormality.
Familial aneurysms of the distal anterior cerebral artery are a neurosurgical rarity. We report a family with four of its members (a mother and three sons) suffering from subarachnoid hemorrhage secondary to ruptured aneurysms, two of them being of the distal anterior cerebral artery. There was no evidence of endocarditis, septic emboli, coarctation of the aorta, or trauma. There was no family history of Marfan's syndrome, polycystic kidney, or hereditary connective tissue disorder. We believe that there has been no report in the neurosurgical literature of familial cases of distal anterior cerebral artery aneurysms.
A new simple method, which allows rapid access to the ventricular system to monitor intracranial pressure, is described. One of the lateral ventricles is punctured percutaneously, with a hand drill operated by a flash-light battery, and a lumbar puncture needle (20 gauge) attached to a water manometer or to a strain gauge connected to a venous pressure monitor.
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Interhemispheric subdural empyema, secondary to frontal sinusitis in two girls is described. Headache, hemiparesis more marked in the lower extremity, fever, focal seizures, stupor and stiff neck were the principal features of the clinical course. The angiographic appearance of the lesion was the key to the preoperative diagnosis. Surgical evacuation of the purulent collection resulted in complete cure in both cases.
A new, safe, simple technique for percutaneous ventriculocentesis has been devised and used in 15 consecutive patients with excellent results and no complications. This method allows rapid access to the ventricular system for diagnostic and therapeutic purposes.
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