The Data of Alienism

1884 ◽  
Vol 30 (131) ◽  
pp. 369-377
Author(s):  
Charles Mercier
Keyword(s):  
Direct Evidence ◽  
Internal Carotid ◽  
Peripheral Circulation ◽  
External Carotid Artery ◽  
The State ◽  
Point Of View ◽  
External Carotid ◽  
External Temperature ◽  
The Face ◽  
Main Thing

Following the estimation of the state of the blood comes naturally that of the state of the circulation; and for the purpose of the alienist the efficiency with which the peripheral circulation is carried on is the main thing to be determined. From his point of view it is of far less importance to discover an insufficiency of the mitral valve than to find a cold blue flabby hand or nose; for a damaged valve is consistent with an efficient supply of blood to the highest nervous centres; but if one part of the peripheral circulation is seen to be badly carried on, the inference is unavoidable that the circulation in other peripheral regions is similarly defective. The direct evidence of the condition of the cerebral circulation obtainable by the ophthalmoscope should not be neglected. Although the “heat of the head” is a matter of prime importance among the laity, and is commonly considered by physicians as of some value, yet, having regard to the fact that the whole of the face and scalp are supplied by branches of the external carotid artery, while the encephalon receives its blood mainly from the internal carotid, I was for some time doubtful whether much stress should be laid on this external temperature. I have, however, seen a case in which not only did the head sweat freely, but steam rose visibly for many consecutive hours from the scalp of a woman lying in a well-warmed ward, and without any fluid or medicament being applied to the head. In that case there was found after death the most excessive congestion of the whole cerebral substance.

Retromandibular Fossa Approach to the High Cervical Internal Carotid Artery: An Anatomic Study

2008 ◽  
Vol 62 (suppl_5) ◽  
pp. ONS363-ONS370 ◽  
Author(s):  
Yusuf Izci ◽  
Roham Moftakhar ◽  
Mark Pyle ◽  
Mustafa K. Basşkaya
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Average Length ◽  
Cranial Nerves ◽  
External Carotid Artery ◽  
External Carotid ◽  
Digastric Muscle ◽  
High Cervical ◽  
Cervical Internal Carotid Artery

Abstract Objective: Access to the high cervical internal carotid artery (ICA) is technically challenging for the treatment of lesions in and around this region. The aims of this study were to analyze the efficacy of approaching the high cervical ICA through the retromandibular fossa and to compare preauricular and postauricular incisions. In addition, the relevant neural and vascular structures of this region are demonstrated in cadaveric dissections. Methods: The retromandibular fossa approach was performed in four arterial and venous latex-injected cadaveric heads and necks (eight sides) via preauricular and postauricular incisions. This approach included three steps: 1) sternocleidomastoid muscle dissection; 2) transparotid dissection; and 3) removal of the styloid apparatus and opening of the retromandibular fossa to expose the cervical ICA with the internal jugular vein along with Cranial Nerves X, XI, and XII. Results: The posterior belly of the digastric muscle and the styloid muscles were the main obstacles to reaching the high cervical ICA. The high cervical ICA was successfully exposed through the retromandibular fossa in all specimens. In all specimens, the cervical ICA exhibited an S-shaped curve in the retromandibular fossa. The external carotid artery was located more superficially than the ICA in all specimens. The average length of the ICA in the retromandibular fossa was 6.8 cm. Conclusion: The entire cervical ICA can be exposed via the retromandibular fossa approach without neural and vascular injury by use of meticulous dissection and good anatomic knowledge. Mandibulotomy is not necessary for adequate visualization of the high cervical ICA.

Dynamic Computed Tomography Angiography in Suspected Brain Death: A Noninvasive Biomarker

2014 ◽  
Vol 65 (4) ◽  
pp. 352-359 ◽  
Author(s):  
Santanu Chakraborty ◽  
Reem A. Adas
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Brain Death ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Ancillary Test ◽  
Organ Harvesting

Purpose Neurologic determination of death or brain death is primarily a clinical diagnosis. This must respect all guarantees required by law and should be determined early to avoid unnecessary treatment and allow organ harvesting for transplantation. Ancillary testing is used in situations in which clinical assessment is impossible or confounded by other factors. Our purpose is to determine the utility of dynamic computed tomographic angiography (dCTA) as an ancillary test for diagnosis of brain death. Materials and Methods We retrospectively reviewed 13 consecutive patients with suspected brain death in the intensive care unit who had dCTA. Contrast appearance timings recorded from the dCTA data were compared to findings from 15 controls selected from patients who presented with symptoms of acute stroke but showed no stroke in follow-up imaging. Results The dCTA allows us to reliably assess cerebral blood flow and to record time of individual cerebral vessels opacification. It also helps us to assess the intracranial flow qualitatively against the flow in extracranial vessels as a reference. We compared the time difference between enhancement of the external and internal carotid arteries and branches. In all patients who were brain dead, internal carotid artery enhancement was delayed, which occurred after external carotid artery branches were opacified. Conclusion In patients with suspected brain death, dCTA reliably demonstrated the lack of cerebral blood flow, with extracranial circulation as an internal reference. Our initial results suggest that inversion of time of contrast appearance between internal carotid artery and external carotid artery branches at the skull base could predict a lack of distal intracranial flow.

scholarly journals RUSSIAN ECONOMY: WHAT IS NOT ENOUGH FOR THE DEVELOPMENT OF INDUSTRIES AND ENTERPRISES

2021 ◽  
pp. 125-133
Author(s):  
A. V. Yaschenko
Keyword(s):  
Theory Of The Firm ◽  
The State ◽  
Point Of View ◽  
Theory And Practice ◽  
High Tech ◽  
State Budget ◽  
Investment Activity ◽  
Russian Economy ◽  
The Government ◽  
Main Thing

The article attempts to assess the results of the development of the Russian economy from the moment of privatization to the present. The urgency of the problem lies in the fact that, despite significant resources, including human capital, the economy is stagnating, there are no structural reforms, and high-tech companies do not appear. The main thing is not creating conditions for business development on the principles of self-organization: entrepreneurship, initiative, personal competence and investment. Reforming the socio-economic system of the USSR has no historical analogue, and is perceived as a unique practice of testing some theoretical positions and hypotheses that guided researchers and entrepreneurs in the framework of a market economy, for example, the theory of market equilibrium, theory of the firm, theory of preferences, and others. Russia has demonstrated a kind of phenomenon, both from the point of view of theory and practice of market transformations, when it is not entrepreneurship, not the investment activity of business and the population, but the narrowly selfish interests of persons affiliated with the government, began to determine market processes, such an economy was called the «economy of individuals», And in the case of a direct focus on the state budget,» the economy of the distribution». The transformations could be based on the market experience of a large number of countries, both developed and developing (China), this has not been done. Time was lost on the creation of new jobs; in the industrial orientation of the state, there were no priorities for the development of important industries for national competitiveness. As a result, the economic growth was lost.

Orbital Vascular And Lymphatic Systems

2012 ◽  
Author(s):  
David Jordan ◽  
Louise Mawn ◽  
Richard L. Anderson
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Cavernous Sinus ◽  
Ophthalmic Artery ◽  
Internal Carotid ◽  
External Carotid Artery ◽  
External Carotid ◽  
Sympathetic Nerve Fibers ◽  
Carotid Canal ◽  
Cervical Ganglion

The anatomy of the orbital vascular bed is complex, with tremendous individual variation. The main arterial supply to the orbit is from the ophthalmic artery, a branch of the internal carotid artery. The external carotid artery normally contributes only to a small extent. However, there are a number of orbital branches of the ophthalmic artery that anastomose with adjacent branches from the external carotid artery, creating important anastomotic communications between the internal and external carotid arterial systems. The venous drainage of the orbit occurs mainly via two ophthalmic veins (superior and inferior) that extend to the cavernous sinus, but there are also connections with the pterygoid plexus of veins, as well as some more anteriorly through the angular vein and the infraorbital vein to the facial vein. A working knowledge of the orbital vasculature and lymphatic systems is important during orbital, extraocular, or ocular surgery. Knowing the anatomy of the blood supply helps one avoid injury to the arteries and veins during operative procedures within the orbit or the eyelid. Inadvertent injury to the vasculature not only distorts the anatomy and disrupts a landmark but also prolongs the surgery and might compromise blood flow to an important orbital or ocular structure. Upon entering the cranium, the internal carotid artery passes through the petrous portion of the temporal bone in the carotid canal and enters the cavernous sinus and middle cranial fossa through the superior part of the forame lacerum . It proceeds forward in the cavernous sinus with the abducens nerve along its side. There it is surrounded by sympathetic nerve fibers (the carotid plexus ) derived from the superior cervical ganglion. It then makes an upward S-shaped turn to form the carotid siphon , passing just medial to the oculomotor, trochlear, and ophthalmic nerves (V1). After turning superiorly in the anterior cavernous sinus, the carotid artery perforates the dura at the medial aspect of the anterior clinoid process and turns posteriorly, inferior to the optic nerve.

scholarly journals Peculiar Characteristics of Arteriovenous Malformations Arising in the Galenic Region

Diagnostics ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 481
Author(s):  
Hirohisa Yajima ◽  
Yuki Shinya ◽  
Hirotaka Hasegawa ◽  
Masahiro Shin ◽  
Keisuke Ueki ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Arteriovenous Malformations ◽  
Internal Carotid ◽  
Obstructive Hydrocephalus ◽  
External Carotid Artery ◽  
Vascular Lesions ◽  
External Carotid ◽  
Vein Of Galen ◽  
Vertebrobasilar Artery ◽  
The University

Arteriovenous malformations (AVM) are congenital vascular lesions fed by arterial feeders originating from branches of the internal carotid artery (ICA) or vertebrobasilar artery. We experienced unique AVMs arising in the midline Galenic region, receiving blood supply from the ICA/vertebral artery systems and the external carotid artery system. We retrospectively reviewed data on eight patients who had an AVM arising in the Galenic region and were treated in the University of Tokyo Hospital between 1990 and 2019. The median age at diagnosis was 62 years. Three cases (38%) presented with obstructive hydrocephalus due to aqueduct obstruction caused by an engorged vein of Galen. In all cases, feeders from dural arteries were present and the vein of Galen was the primary drainer. All patients underwent stereotactic radiosurgery. Five patients were followed for > two years; nidus obliteration was confirmed in one, and > 75% shrinkage was confirmed in three, while one patient died due to hemorrhage. Altogether, AVMs arising in the Galenic region are rare and exhibit several peculiar characteristics including the presence of dural feeders, an older age at presentation and presentation with obstructive hydrocephalus.

scholarly journals Type D Traumatic Carotido-Cavernous Fistula Due to Selective Transection of the Inferolateral Trunk(ILT)

2003 ◽  
Vol 9 (4) ◽  
pp. 373-377 ◽  
Author(s):  
I.C. Duncan ◽  
P.A. Fourie
Keyword(s):  
Carotid Arteries ◽  
Internal Carotid ◽  
Traumatic Injury ◽  
External Carotid Artery ◽  
External Carotid ◽  
Type D ◽  
Type C ◽  
Transvenous Approach ◽  
Internal Carotid Arteries ◽  
Inferolateral Trunk

A minority of traumatic carotido-cavernous fistulas (CCF) are of the indirect variety, and then usually supplied only by meningeal branches of the ipsilateral external carotid artery (Type C). We describe a case of a Type D CCF due to traumatic injury of the inferolateral trunk (ILT), and describe its angiographic features and endovascular management through both the external and internal carotid arteries following a failed transvenous approach.

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