The influence of hypothalamic lesions on metabolism and peripheral organization [proceedings].
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Biomedical subjects
Publications and source records attributed to H W Pia.
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Microsurgery has improved the treatment of cerebral aneurysms techically and by more detailed knowledge of the topographic relations, the variations, and the anomalies of the involved arteries. A personal study of 450 aneurysms formed the basis of a modified and more detailed classification of aneurysms of the carotid system. It was confirmed that aneurysms originate at the junctions of arteries, and generally project according to the course of the vessel involved. The origins and projections aneurysms and their different sites were analyzed with the aid of angiography, angiotomography, magnification angiography, operative drawings, photographs, and films, which permitted the establishment of a special classification for every particular form. Preoperative knowledge of the types of aneurysms facilitates the surgical procedures and results in lowered morbidity.
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A classification of aneurysms of the posterior cerebral artery from a series of 8 personal cases and 34 cases collected from the literature is attempted. The classification is based on the topography and sites of origin of the cortical and central branches of the artery. The artery was divided into six sections which permitted the description of the origin and projection of typical aneurysms. Single cases of atypical aneurysms can be explained by the known vascular anomalies. The predilective site is section B (origins of the posteromedial choroidal artery and quadrigeminal artery), then section D with the main division of the posterior cerebral artery and origins of the anterior temporal artery, the anterior posterolateral choroidal artery, the hippocampal artery and the thalamogeniculate artery, and finally section C--the junction with the posterior communicating artery. Clinical syndromes corresponding to these locations are described. The classification, when considered together with improved angiographic technique and microsurgery, allows exact preoperative and peroperative definition of topography which in turn enables the avoidance of injury to functionally important typical and atypical central branches of the posterior cerebral artery.
Sterilization of the operating microscope and its equipment with formaldehyde (10 g for 10 hours) in a specially developed container provides sterility and ideal storage, and secures immediate availability in daily operating theatre practice.
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