The isolation and transplantation of the brain. An historical perspective emphasizing the surgical solutions to the design of these classical models.

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.

Myelin and microsomes from rhesus monkey spinal cord: isolation and effects of trauma.

Dispersions of rhesus monkey spinal cord and brain were separated into large particle (crude mitochondrial plus nuclear) and small particle (crude microsomal) fractions; myelin was isolated from each of these preparative fractions. In brain preparations, almost all myelin was found in the large particle fraction; in contrast, almost half the myelin from spinal cord preparations was found in the small particle fraction. In addition, much larger amounts of partially degraded myelin were found in the fraction floating on 0.

Chronic intracerebral hematoma.

Twelve patients with chronic intracerebral hematoma are reported. This condition may be unrecognized as possibly being benefited by relatively simple diagnostic and therapeutic measures. The neurological symptoms and signs may be acute but may also be intermittent and progressive.

Vasoactive properties of prostaglandin compounds on the in vitro human basilar artery.

The action of six prostaglandins A1, E1, (A2, E2, F1 alpha, F2 alpha) on in vitro human basilar artery circumferential strips was evaluated to assess relative vasoreactivity. Degree of contraction was compared with 5-hydroxytryptamine (5-HT), hitherto the most active in this laboratory. The three most vasoactive prostaglandins were E1, E2, and F2, alpha.

Chromophobe adenoma and chiasmal syndrome without enlargement of the bony sella.

Four cases of chiasmal syndrome resulting from chromophobe adenoma with normal-sized sella turcica are reported. The predominantly suprasellar growth of these tumors was probably the result of a well-pneumatized sphenoid sinus and/or a congenitally deficient diaphragma sellae. In patients with chiasmal syndrome, a high suspicion of a surgically treatable lesion must be maintained in spite of radiographs showing a normal-sized sella.

A neuroanatomical analysis of spinal cord injury in the rhesus monkey (Macaca mulatta).

Thirteen rhesus monkeys were subjected to impacts of either 200, 300, 400, oe 500 g-cm, on the dorsal surface of the spinal cord (Allen 1911). Six monkeys served as controls to determine the results of transection of the cord as well as the optimal survival time, and 2 additional subjects underwent the operative procedures only. Most of the animals were sacrificed 1 week postoperatively and the brains and spinal cords were processed by the Fink and Heimer (1967) technique for degenerating axons.

Narrow lumbar spinal canal with "vascular" syndromes.

Symptoms suggestive of vascular origin, both venous and arterial, may be the presenting complaints in patients with lumbar spondylosis. Fourteen patients suspected of having vascular intermittent claudication were found to be free of vascular disease, but had cauda equina compromise from herniated disk, osteoarthritis, and hypertrophic ligaments. Complete follow-up data were available for seven patients.

Treatment of Jefferson fracture with a halo apparatus. Report of two cases.

Two patients with bursting fractures of the atlas vertebra are presented. The use of a halo apparatus as an effective alternative to bedrest and cervical traction in these patients is discussed. Polytomography was helpful in establishing an accurate diagnosis.

Programmed management of acute cervical cord trauma.

Results in ten patients admitted with the diagnosis of complete traumatic quadriplegia and with fracture-dislocation of the cervical spine are reviewed. Emphasis is placed on aggressive emergency surgical treatment of these lesions such as tracheostomy, laminectomy and cord cooling, incorporated into a detailed protocol of overall management.

Effects of anesthesia level and stimulus characteristic on the amplitude and latency of the somatosensory evoked response in monkeys.

The effect on the somatosensory evoked response (SER) of the level of anesthesia, and the effect of the site, intensity, duration, and frequency of the stimulus on the amplitude and latency of various components of the SER were studied in 8 Rhesus monkeys. Peroneal nerve stimulation produced similar patterns over both sides of the head, with a slightly larger amplitude over the contralateral cortex. With ulnar nerve stimulation, significantly different patterns were observed over the contralateral and ipsilateral cortex; however, the former still had a slightly larger amplitude.

Rapid closed reduction of cervical fracture dislocations.

Indications and a procedure for rapid closed reduction and decompression of cervical fracture dislocations in less than two hours by tong traction are described. Large amounts of weight are utilized. Neurologic damage due either to the large amount of weight or to rapidity of reduction has not been observed.

Systemic hypotension in neurosurgery.

The authors review the intraoperative use of elective hypotension to reduce the probability of hemorrhage, to increase pliability of the aneurysmal sac for ease of clip application, and to control hemorrhage. The optimum agent and techniques for lowering systemic blood pressure remain controversial, but trimethaphan, sodium nitroprusside, and halothane have been found most useful. When cerebral blood flow falls below the brain's capacity to autoregulate, distinct time-related alterations occur biochemically and histologically.

Blood flow in normal and injured monkey spinal cord.

The authors used indicator fractionation techniques to determine blood flow in normal and bluntly traumatized spinal cords of Macaca rhesus monkeys. Normal flow rates were determined for several levels of spinal cord as well as differential values for white and gray matter from representative areas. Flow rates in traumatized tissue, obtained at several different time intervals up to 4 hours after injury, demonstrated marked differences in regional perfusion of the white matter and gray matter after trauma.

Intracellular enzyme liberation in primate spinal cord injury.

Intracellular lysosomal and nonlysosomal enzymes, as well as tissue edema, were measured in spinal cords of monkeys up to 20 days following a 300 gm-cm open injury. Although edema was maximal between six hours and 11 days, enzyme elevation was delayed. Lysosomal enzyme acid cathepsin increased beginning at five days and the beta-glucuronidase and beta-glycerophosphatase increase began at 11 days.

Astrocytic processes: A route between vessels and neurons followingblood-brain barrier injurt.

The fluorescent tracer Evans blue (EB) was studied after circulation time ranging from 30 seconds to 5 minutes following blood-brain barrier (BBB) injuries in 42 dogs. Selective neuronal stainings (sns), associated with BBB injuries, occurred to a high degree. This phenomenon was examined by modifications in existing fluorescence techniques.

Quantitative in vitro vasoactivity of 5-hydroxytryptamine on the human basilar artery.

The importance of autacoidal substances in the genesis of cerebral vascular constriction and spasm is an unresolved issue. Comparative vasoactivity of 5-hydroxytryptamine (5HT) and norepinephrine (NE) on the human basilar artery was quantitatively assessed in vitro. 5HT was decidedly more vasoactive in this preparation.

Fluorescence microscopy in tumors of central nervous system: a method of recognizing malignancy with acridine orange.

Tumors of the central nervous system were stained with acridine orange. Photographs were taken during observation through ultraviolet light. Cellular detail was not recognizable but malignant tumors fluoresced more than benign tumors.