Vasospastic Phenomena on the Luminal Replica of Rat Brain Vessels

Strikingly localized ring-like constrictions (other than sphincters, cushions and offshoot furrows) have appeared on the casted vessels of some of our preparations. Morphology of the phenomena reveals diverse degree of active contraction of the vessel wall, ranging from corrugation of the luminal surface to near severance of the acrylic cast. Distribution of the vasospastic phenomena reveals as particularly affected the arteries in the diameter range between 25 and 75 μm, that belong either to intra-arterial anastomoses between the branches of each of the three major cerebral arteries or to their terminal junctions in the border zones (inter-arterial anastomoses). Among the possible causes for the occurrence of the observed vasospasms, we indicate the susceptibility to raised intraluminal pressure during injection, producing contraction of the smooth muscle cell. Reactivity appears heightened in the anastomotic districts of the circulation. The evidence of so-called plastic strips clinging to constricted sections of affected vessels prompts re-examination of their proposed origin as plastic wrapping . Rather, they appear to be remnants of dynamic elements of the vascular wall (smooth muscle cells) that resisted corrosion

The Capillary Bed in the Choroid Plexus of the Lateral Ventricles: A Study of Luminal Casts

Micro-angioarchitecture of the choroid plexus of the lateral ventricles is investigated in microcorrosion casts of animal and human preparations studied with the scanning electron microscope. The capillary bed in the diverse regions of the tissue belongs to one of three patterns: (1)-a network of capillary meshes that envelop the larger arteries and veins predominates in the central segment. (2)-in the villous regions a leaf-like organization of sinusoids is found together with (3)-fronds of glomerular formations. Glomeruli are formed when arterial afferents and venous efferents converge in a quasi hilar structure before branching in arterio-venous loops. Nodular thickenings are observed on glomerular capillaries The preparations studied (rat, dog, human) are remarkably similar and differ mostly in degree of occurrence of common architectural patterns. Arterio-venous communications are found at the hilus of human glomerular formations

Defining Meyer's loop-temporal lobe resections, visual field deficits and diffusion tensor tractography

Anterior temporal lobe resection is often complicated by superior quadrantic visual field deficits (VFDs). In some cases this can be severe enough to prohibit driving, even if a patient is free of seizures. These deficits are caused by damage to Meyer's loop of the optic radiation, which shows considerable heterogeneity in its anterior extent. This structure cannot be distinguished using clinical magnetic resonance imaging sequences. Diffusion tensor tractography is an advanced magnetic resonance imaging technique that enables the parcellation of white matter. Using seed voxels antero-lateral to the lateral geniculate nucleus, we applied this technique to 20 control subjects, and 21 postoperative patients. All patients had visual fields assessed with Goldmann perimetry at least three months after surgery. We measured the distance from the tip of Meyer's loop to the temporal pole and horn in all subjects. In addition, we measured the size of temporal lobe resection using postoperative T1-weighted images, and quantified VFDs. Nine patients suffered VFDs ranging from 22% to 87% of the contralateral superior quadrant. In patients, the range of distance from the tip of Meyer's loop to the temporal pole was 24–43 mm (mean 34 mm), and the range of distance from the tip of Meyer's loop to the temporal horn was –15 to +9 mm (mean 0 mm). In controls the range of distance from the tip of Meyer's loop to the temporal pole was 24–47 mm (mean 35 mm), and the range of distance from the tip of Meyer's loop to the temporal horn was –11 to +9 mm (mean 0 mm). Both quantitative and qualitative results were in accord with recent dissections of cadaveric brains, and analysis of postoperative VFDs and resection volumes. By applying a linear regression analysis we showed that both distance from the tip of Meyer's loop to the temporal pole and the size of resection were significant predictors of the postoperative VFDs. We conclude that there is considerable variation in the anterior extent of Meyer's loop. In view of this, diffusion tensor tractography of the optic radiation is a potentially useful method to assess an individual patient's risk of postoperative VFDs following anterior temporal lobe resection

Microneurosurgical Anastomoses for Cerebral Ischemia [Contents]

From jacket: The purpose of this volume is to present a series of important papers on the rapidly growing surgical field of microneurosurgical anastomoses for cerebral ischemia. It includes papers on the indications and results of microneurosurgical bypass anastomoses; on the techniques used to study patients before and after surgery, including cerebral blood flow psychometic testing, etc.; and on the basic mechanisms of cerebral ischemia studies in animals. New ideas are suggested for techniques involving increased use of the occipital arteries and the development of vein, arterial, or prosthetic grafts in place of the STA (superficial temporal artery). Also discussed are the importance of measuring blood flow in the STA where possible, and the measurement of cerebral blood flow pre- and postoperatively to monitor the results. Psychometric studies are shown to be of importance pre- and postoperatively in addition to careful neurologic evaluation