IN a recent paper Lewis (1939-42) has reviewed the evidence concerning the nature of the fibres concerned in axonal vasodilatation and has affirmed his belief that while they belong to the posterior root system they are not afferent fibres. Support for this contention might be obtained from the following case, though here a different interpretation is made. The opportunity is also taken to present an alternative to the explanation of Lewis for certain of the phenomena associated with the flare.
{"title":"STUDIES IN DENERVATION: D.-THE MECHANISM OF AXONAL VASODILATATION.","authors":"J Doupe","doi":"10.1136/jnnp.6.3-4.115","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.115","url":null,"abstract":"IN a recent paper Lewis (1939-42) has reviewed the evidence concerning the nature of the fibres concerned in axonal vasodilatation and has affirmed his belief that while they belong to the posterior root system they are not afferent fibres. Support for this contention might be obtained from the following case, though here a different interpretation is made. The opportunity is also taken to present an alternative to the explanation of Lewis for certain of the phenomena associated with the flare.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
nerve cells surrounding the deposits have undergone various amounts ofdestruction. Silversections show that the plexus of nerve fibres is less dense than in the normal globus pallidus, and many of the fibres show degenerative changes such as frag-mentation and irregular thickenings. The deposits were first thought to be entirely of a calcareous nature, but they were found to give a strong positive reaction for iron in preparations treated with hydrochloric acid and potassium ferrocyanide. In these preparations the substance of the globus pallidus itself also stains a more intense blue than normal.
{"title":"SIDEROSIS OF THE GLOBUS PALLIDUS IN A MONKEY.","authors":"P Glees","doi":"10.1136/jnnp.6.3-4.92","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.92","url":null,"abstract":"nerve cells surrounding the deposits have undergone various amounts ofdestruction. Silversections show that the plexus of nerve fibres is less dense than in the normal globus pallidus, and many of the fibres show degenerative changes such as frag-mentation and irregular thickenings. The deposits were first thought to be entirely of a calcareous nature, but they were found to give a strong positive reaction for iron in preparations treated with hydrochloric acid and potassium ferrocyanide. In these preparations the substance of the globus pallidus itself also stains a more intense blue than normal.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.92","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
THE following history of imbecility in eleven males of two generations was brought to our notice some years ago when a child aged.eighteen months, now indicated as V 54 on the adjoining pedigree chart, was brought to the outpatient department at the National Hospital by his mother who suspected that he was showing the signs of mental deficiency which she had already seen develop in some of the sons of her sisters; she was further aware of the condition in her cousins IV 13 and 14. The mother of the patient, IV 22, was intelligent and was much concerned about the family history; she provided at that time complete information regarding her own branch of the family and obtained the collaboration of her aunt, III 1, in working out the extended pedigree, including the three defective brothers V 16, 18, and 19. At this time one of us (J.P.M.) visited many of the descendants of III 4; he noted the undoubted intelligence of the seven daughters of III 4 and examined their defective sons in institutions or in their homes. More recently we have been able to get in touch with some of the descendants of III 2 and to see the three imbecile sons of IV 3. This side of the pedigree has been much extended since the original history was given by III 1, and to some extent modified. Our information was provided by IV 3 and 4, but they did not welcome inquiry and discouraged our attempt to see the only other living member of the sibship IV 1-11, or to call upon V 13. IV 3 was uncertain about some details regarding the sex and number of her nieces and nephews and we did not feel assured that she would know if, for example, IV 2, or IV 9 had had defective sons or grandsons. Two of the twins of IV 2 had died in infancy, but IV 3 did not know whether they had been boys or girls. It is illustrative of the secretive-ness of this branch of the family that at the time of the earlier pedigree III 1 was unaware that she had any grandchildren through her daughter IV 2, or that her son IV 1 had more than one child. IV 3 was fiercely protective in her attitude to her imbecile sons and resentful that, when found as small boys wandering in …
{"title":"A PEDIGREE OF MENTAL DEFECT SHOWING SEX-LINKAGE.","authors":"J P Martin, J Bell","doi":"10.1136/jnnp.6.3-4.154","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.154","url":null,"abstract":"THE following history of imbecility in eleven males of two generations was brought to our notice some years ago when a child aged.eighteen months, now indicated as V 54 on the adjoining pedigree chart, was brought to the outpatient department at the National Hospital by his mother who suspected that he was showing the signs of mental deficiency which she had already seen develop in some of the sons of her sisters; she was further aware of the condition in her cousins IV 13 and 14. The mother of the patient, IV 22, was intelligent and was much concerned about the family history; she provided at that time complete information regarding her own branch of the family and obtained the collaboration of her aunt, III 1, in working out the extended pedigree, including the three defective brothers V 16, 18, and 19. At this time one of us (J.P.M.) visited many of the descendants of III 4; he noted the undoubted intelligence of the seven daughters of III 4 and examined their defective sons in institutions or in their homes. More recently we have been able to get in touch with some of the descendants of III 2 and to see the three imbecile sons of IV 3. This side of the pedigree has been much extended since the original history was given by III 1, and to some extent modified. Our information was provided by IV 3 and 4, but they did not welcome inquiry and discouraged our attempt to see the only other living member of the sibship IV 1-11, or to call upon V 13. IV 3 was uncertain about some details regarding the sex and number of her nieces and nephews and we did not feel assured that she would know if, for example, IV 2, or IV 9 had had defective sons or grandsons. Two of the twins of IV 2 had died in infancy, but IV 3 did not know whether they had been boys or girls. It is illustrative of the secretive-ness of this branch of the family that at the time of the earlier pedigree III 1 was unaware that she had any grandchildren through her daughter IV 2, or that her son IV 1 had more than one child. IV 3 was fiercely protective in her attitude to her imbecile sons and resentful that, when found as small boys wandering in …","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.154","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. A. MCCONNELL Six patients who had sustained concussion and had become accessible continued in a state of amnesia for over five days. Exploratory operations were performed. In one case nothing abnormal was found; in five cases a definite subdural effusion (" subdural hydroma ") was present. It was suggested that the subdural effusion had been a factor in the prolongation of the amnesia following concussion. The fluid accumulation was bilateral in two of the cases. The volume of the hydroma was as much as 200 c.c. in one case, and the protein content of the fluid was recorded as high as 3 per cent. Rapid improvement in symptoms following evacuation of the hydroma was evidence of its importance in maintaining disability.
{"title":"SOCIETY OF BRITISH NEUROLOGICAL SURGEONS.","authors":"","doi":"10.1136/jnnp.6.3-4.158","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.158","url":null,"abstract":"A. A. MCCONNELL Six patients who had sustained concussion and had become accessible continued in a state of amnesia for over five days. Exploratory operations were performed. In one case nothing abnormal was found; in five cases a definite subdural effusion (\" subdural hydroma \") was present. It was suggested that the subdural effusion had been a factor in the prolongation of the amnesia following concussion. The fluid accumulation was bilateral in two of the cases. The volume of the hydroma was as much as 200 c.c. in one case, and the protein content of the fluid was recorded as high as 3 per cent. Rapid improvement in symptoms following evacuation of the hydroma was evidence of its importance in maintaining disability.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
THE influence of the vasomotor nerves on the circulation in the fingers and toes is readily demonstrable and has been extensively studied. It is, however, much more difficult to demonstrate the nervous regulation of the circulation in the skin of the proximal parts of the limbs and relatively few observations bearing on this aspect of the circulation have been recorded, while only Grant and Holling (1937-8) have made it the object of detailed study. These authors found that very intense warming of the body produced an increased flow of blood in the skin of the limbs proximal to the hands and feet and by their method of occluding the circulation distal to the points under observation they were able to show that this increase was local and not merely a reflection of the changes occurring more peripherally. They then made experiments to elucidate the nature of this vasodilatation. They demonstrated that body warming failed to cause this vasodilatation after section of the sympathetic nerves or after cutting or blocking the local nerve supply of the skin. They next demonstrated that a local nerve block when the subject was cold did not cause a vasodilatation such as results in the digits and they made the complementary observation showing that a nerve block in the presence of vasodilatation caused a vasoconstriction. From these facts they concluded that the blood vessels of the skin of the proximal part of the limbs are supplied by vasodilator nerves of sympathetic origin. In reporting their observations Grant and Holling ieft two points for future clarification. The first of these was in regard to the importance of the part played by the activity of the sweat glands in determining the vasodilatation, though it was considered that this was likely to be small because a temporal coincidence of sweating and vasodilatation was sometimes absent. The second question related to explanation of the vasodilatation which they observed in the skin of the proximal parts of the limbs for the first week following sympathectomy. It is the purpose of this paper to record results substantiating those of Grant and Holling and to contribute to the solution of these two problems.
{"title":"STUDIES IN DENERVATION: F.-THE CIRCULATION IN THE SKIN OF THE PROXIMAL PARTS OF THE LIMBS.","authors":"J Doupe, C H Cullen, L J Macaulay","doi":"10.1136/jnnp.6.3-4.129","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.129","url":null,"abstract":"THE influence of the vasomotor nerves on the circulation in the fingers and toes is readily demonstrable and has been extensively studied. It is, however, much more difficult to demonstrate the nervous regulation of the circulation in the skin of the proximal parts of the limbs and relatively few observations bearing on this aspect of the circulation have been recorded, while only Grant and Holling (1937-8) have made it the object of detailed study. These authors found that very intense warming of the body produced an increased flow of blood in the skin of the limbs proximal to the hands and feet and by their method of occluding the circulation distal to the points under observation they were able to show that this increase was local and not merely a reflection of the changes occurring more peripherally. They then made experiments to elucidate the nature of this vasodilatation. They demonstrated that body warming failed to cause this vasodilatation after section of the sympathetic nerves or after cutting or blocking the local nerve supply of the skin. They next demonstrated that a local nerve block when the subject was cold did not cause a vasodilatation such as results in the digits and they made the complementary observation showing that a nerve block in the presence of vasodilatation caused a vasoconstriction. From these facts they concluded that the blood vessels of the skin of the proximal part of the limbs are supplied by vasodilator nerves of sympathetic origin. In reporting their observations Grant and Holling ieft two points for future clarification. The first of these was in regard to the importance of the part played by the activity of the sweat glands in determining the vasodilatation, though it was considered that this was likely to be small because a temporal coincidence of sweating and vasodilatation was sometimes absent. The second question related to explanation of the vasodilatation which they observed in the skin of the proximal parts of the limbs for the first week following sympathectomy. It is the purpose of this paper to record results substantiating those of Grant and Holling and to contribute to the solution of these two problems.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.129","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction IT is proposed to report under the above general heading a number of investigations on patients with peripheral nerve lesions. The following titles indicate the nature of the papers. A. Methods. B. The Circulation in Denervated Digits. C. Inflammation and Trophic Ulcers in Denervated Areas. D. The Mechanism of Axonal Vasodilatation. E. Observations Concerning Adrenaline. F. The Circulation of the Skin of the Proximal Parts of the Limbs. G. Sebaceous Secretion. H. The Effect of Electrical Treatment on the Circulation and Recovery of Denervated Muscles. I. The Contractilityand Excitability of Denervated Muscle. The original intention of bringing these studies within the compass of one or two papers has been found impractical and for convenience of presentation and of reference the work has been divided into sections. These sections will be found to be of unequal merit as some merely report incidental observations which have not been elaborated. Another disadvantage of this method of presentation is that it leads to unnecessary repetition. This, however, has been obviated by the Editor who has kindly arranged to publish the papers seriatim. This grouping permits a single description of the patients and methods to suffice for the majority of these studies and allows of ready reference between papers. It is the purpose of the present paper to describe the methods and the subjects used in these investigations.
{"title":"STUDIES IN DENERVATION: A.-METHODS.","authors":"J Doupe","doi":"10.1136/jnnp.6.3-4.94","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.94","url":null,"abstract":"Introduction IT is proposed to report under the above general heading a number of investigations on patients with peripheral nerve lesions. The following titles indicate the nature of the papers. A. Methods. B. The Circulation in Denervated Digits. C. Inflammation and Trophic Ulcers in Denervated Areas. D. The Mechanism of Axonal Vasodilatation. E. Observations Concerning Adrenaline. F. The Circulation of the Skin of the Proximal Parts of the Limbs. G. Sebaceous Secretion. H. The Effect of Electrical Treatment on the Circulation and Recovery of Denervated Muscles. I. The Contractilityand Excitability of Denervated Muscle. The original intention of bringing these studies within the compass of one or two papers has been found impractical and for convenience of presentation and of reference the work has been divided into sections. These sections will be found to be of unequal merit as some merely report incidental observations which have not been elaborated. Another disadvantage of this method of presentation is that it leads to unnecessary repetition. This, however, has been obviated by the Editor who has kindly arranged to publish the papers seriatim. This grouping permits a single description of the patients and methods to suffice for the majority of these studies and allows of ready reference between papers. It is the purpose of the present paper to describe the methods and the subjects used in these investigations.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.94","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
THE clear demonstration of Bruce (1913) that the inflammatory response ofthe conjunctiva to mustard oil is dependent on the presence of intact afferent neurones and is mediated by axone reflexes has been accorded general agreement
{"title":"STUDIES IN DENERVATION: C.-INFLAMMATION AND TROPHIC ULCERS IN DENERVATED AREAS.","authors":"J Doupe, C H Cullen","doi":"10.1136/jnnp.6.3-4.112","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.112","url":null,"abstract":"THE clear demonstration of Bruce (1913) that the inflammatory response ofthe conjunctiva to mustard oil is dependent on the presence of intact afferent neurones and is mediated by axone reflexes has been accorded general agreement","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effect of Injections of Adrenaline In paper B reference has been made to the demonstration of Fatherree et al. (1940) that denervation of the digital vessels of humans renders them hypersensitive to the vasoconstricting action of adrenaline. Atlas (1938) had previously shown the same phenomenon using neosynephrine and both authors agreed in attributing the action to the effects of degeneration of the sympathetic fibres. These effects were first fully described by Elliott (1905) and since have been amply confirmed though little new has been added to his observations. Freeman et al. (1934) demonstrated in the human the hypersensitivity to adrenaline produced by sympathetic ganglionectomy while the success of the operations of preganglionic sympathectomy devised by Telford (1935) and Smithwick (1936) further testifies to the fact that Elliott's results are applicable to the human. In as much as the present findings form no exception to those referred to above it is only necessary to refer to the figures illustrating these results. Fig. 1 is an enlargement of Fig. 5, paper B, showing that in response to intravenous injections of adrenaline the denervated digit (R.F.2) had a greater fall in temperature than did the preganglionectomized digit (R.F.5), while there was no certain effect on the normal digit (L.F.2). This figure well depicts the prolonged response in the vessels whose sympathetic fibres have degenerated as described by Elliott. It was on the basis of this type of response in R.F.5 and its absence in R.F.2 in subject S.S. (see Fig. 6, paper B) that it was concluded
{"title":"STUDIES IN DENERVATION: E.-OBSERVATIONS CONCERNING ADRENALINE.","authors":"J Doupe","doi":"10.1136/jnnp.6.3-4.121","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.121","url":null,"abstract":"Effect of Injections of Adrenaline In paper B reference has been made to the demonstration of Fatherree et al. (1940) that denervation of the digital vessels of humans renders them hypersensitive to the vasoconstricting action of adrenaline. Atlas (1938) had previously shown the same phenomenon using neosynephrine and both authors agreed in attributing the action to the effects of degeneration of the sympathetic fibres. These effects were first fully described by Elliott (1905) and since have been amply confirmed though little new has been added to his observations. Freeman et al. (1934) demonstrated in the human the hypersensitivity to adrenaline produced by sympathetic ganglionectomy while the success of the operations of preganglionic sympathectomy devised by Telford (1935) and Smithwick (1936) further testifies to the fact that Elliott's results are applicable to the human. In as much as the present findings form no exception to those referred to above it is only necessary to refer to the figures illustrating these results. Fig. 1 is an enlargement of Fig. 5, paper B, showing that in response to intravenous injections of adrenaline the denervated digit (R.F.2) had a greater fall in temperature than did the preganglionectomized digit (R.F.5), while there was no certain effect on the normal digit (L.F.2). This figure well depicts the prolonged response in the vessels whose sympathetic fibres have degenerated as described by Elliott. It was on the basis of this type of response in R.F.5 and its absence in R.F.2 in subject S.S. (see Fig. 6, paper B) that it was concluded","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ONE of the commonest adjuncts to the treatment of peripheral nerve injuries is the electrical stimulation of the paralysed muscles. Despite the nearly universal employment of this procedure for over 40 years there is still doubt as to its value. That the experience gained in the last war resulted in no definite decision is evident from the conflicting views expressed by W. J. Turrell, W. R. Bristow, F. Hernaman-Johnson and others in a discussion of a paper by Burke (1918). At present it would appear that the majority of physiotherapists as oepresented by Kovacs (1940), Cowan (1940), and Mennel (1942) regard the treatment as being of value.. However, Langley and Hashimoto (1918) have stressed the difficulty of assessing its worth in the human because of the many variable factors affecting the recovery of function after lesions of peripheral nerves. A demonstration of this variability of recovery is given in Fig. 1, in which is plotted the time to the first return of voluntary power of the extensor carpi radialis in an unselected group of patients with lesions of the musculo-spiral nerve. The cases without division of the nerve show a wide distribution unrelated to the level of the lesion and they are therefore unsatisfactory for evaluating the effects of therapy. The cases in which the musculo-spiral nerve was sutured ran a fairly predictable course, and since the results of therapeutic procedures must be evaluated in the human, such cases are considered the only suitable material for such an investigation.
{"title":"STUDIES IN DENERVATION: H.-THE EFFECT OF ELECTRICAL STIMULATION ON THE CIRCULATION AND RECOVERY OF DENERVATED MUSCLE.","authors":"J Doupe, R Barnes, A S Kerr","doi":"10.1136/jnnp.6.3-4.136","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.136","url":null,"abstract":"ONE of the commonest adjuncts to the treatment of peripheral nerve injuries is the electrical stimulation of the paralysed muscles. Despite the nearly universal employment of this procedure for over 40 years there is still doubt as to its value. That the experience gained in the last war resulted in no definite decision is evident from the conflicting views expressed by W. J. Turrell, W. R. Bristow, F. Hernaman-Johnson and others in a discussion of a paper by Burke (1918). At present it would appear that the majority of physiotherapists as oepresented by Kovacs (1940), Cowan (1940), and Mennel (1942) regard the treatment as being of value.. However, Langley and Hashimoto (1918) have stressed the difficulty of assessing its worth in the human because of the many variable factors affecting the recovery of function after lesions of peripheral nerves. A demonstration of this variability of recovery is given in Fig. 1, in which is plotted the time to the first return of voluntary power of the extensor carpi radialis in an unselected group of patients with lesions of the musculo-spiral nerve. The cases without division of the nerve show a wide distribution unrelated to the level of the lesion and they are therefore unsatisfactory for evaluating the effects of therapy. The cases in which the musculo-spiral nerve was sutured ran a fairly predictable course, and since the results of therapeutic procedures must be evaluated in the human, such cases are considered the only suitable material for such an investigation.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
SINCE the introduction of lumbar puncture as a therapeutic and diagnostic procedure in acute head injuries by Quincke in 1904, much has been written on the subject, particularly in regard to the indications and contra-indicationsfor the procedure. Nevertheless, whilst the alteration in pressure, cytology and chemistry of the cerebrospinal fluid occurring in the acute state following a head injury has already been frequently discussed (usually in terms of clinical impressions) in the literature, there still seems to be room for further factual studies of the resultant changes on the lines notably adopted by Ritchie Russell (1932); particularly as these changes naturally have an important bearing on the treatment of acute head injuries, on which there are not a few conflicting views at the present time. This investigation was undertaken, therefore, with a view to assessing the actual changes in cerebrospinal fluid pressure, the frequency and the degree of subarachnoid bleeding demonstrable by early lumbar puncture in acute head injuries, as well as the relation of these changes to such factors as severity of injury and the resultant alteration in the mental state.
{"title":"SOME OBSERVATIONS ON THE CEREBROSPINAL FLUID IN CLOSED HEAD INJURIES.","authors":"J H Paterson","doi":"10.1136/jnnp.6.3-4.87","DOIUrl":"https://doi.org/10.1136/jnnp.6.3-4.87","url":null,"abstract":"SINCE the introduction of lumbar puncture as a therapeutic and diagnostic procedure in acute head injuries by Quincke in 1904, much has been written on the subject, particularly in regard to the indications and contra-indicationsfor the procedure. Nevertheless, whilst the alteration in pressure, cytology and chemistry of the cerebrospinal fluid occurring in the acute state following a head injury has already been frequently discussed (usually in terms of clinical impressions) in the literature, there still seems to be room for further factual studies of the resultant changes on the lines notably adopted by Ritchie Russell (1932); particularly as these changes naturally have an important bearing on the treatment of acute head injuries, on which there are not a few conflicting views at the present time. This investigation was undertaken, therefore, with a view to assessing the actual changes in cerebrospinal fluid pressure, the frequency and the degree of subarachnoid bleeding demonstrable by early lumbar puncture in acute head injuries, as well as the relation of these changes to such factors as severity of injury and the resultant alteration in the mental state.","PeriodicalId":54783,"journal":{"name":"Journal of Neurology and Psychiatry","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1943-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1136/jnnp.6.3-4.87","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40109749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：