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EXPERIENCES WITH INTRAMEDULLARY TRACTOTOMY: III. STUDIES IN SENSATION

EXPERIENCES WITH INTRAMEDULLARY TRACTOTOMY: III. STUDIES IN SENSATION Abstract The new operation of intramedullary tractotomy (Sjöqvist) has reawakened an interest in the anatomic arrangement and physiologic functions of the fibers composing the descending tract of the trigeminal nerve. Current ideas on these matters have been derived largely from clinicopathologic observations in cases of thrombosis of the posterior inferior cerebellar artery and of syringobulbia in which the intramedullary trigeminal fibers were involved in the pathologic process. Lesions of this character, because of their irregular size and intensity of destruction, have obvious disadvantages when a study of the clinical effects relating to impairment of a single structure or of an isolated tract is desired. Surgical transection of the descending tract of the trigeminal nerve in man, performed by means of a small controlled incision into the tuberculum cinereum, obviates many of the former difficulties and allows for the first time correlation of sensory changes with a small lesion accurately placed in References 1. Grant, F. C.; Groff, R. A., and Lewy, F. H.: Section of the Descending Root of the Fifth Cranial Nerve , Arch. Neurol. & Psychiat. 43:498 ( (March) ) 1940. 2. von Frey, M.: Untersuchungen über die Sinnesfunktion der menschlichen Haut: I. Druckempfindung und Schmerz , Abhandl. d. math.-phys. Cl. d. k. Sachs. Gesellsch. d. Wissensch. 45:175, 1896. 3. Spiller, W. G.: Remarks on the Central Representation of Sensation , J. Nerv. & Ment. Dis. 42:399, 1915. 4. Stopford, J. S.: The Function of the Spinal Nucleus of the Trigeminal Nerve , J. Anat. 59:120, 1924. 5. Gerard, M. W.: Afferent Impulses of the Trigeminal Nerve, Intramedullary Course of Painful, Thermal and Tactile Impulses , Arch. Neurol. & Psychiat. 9: 306 ( (March) ) 1923. 6. Walker, E. A.: Anatomy, Physiology and Surgical Considerations of the Spinal Tract of the Trigeminal Nerve , J. Neurophysiol. 2:234, 1939. 7. Sjöqvist, O.: Studies on Pain Conduction in the Trigeminal Nerve , Acta psychiat. et neurol. , 1938, (supp. 17) . 8. Smyth, G. E.: The Systemization and Central Connections of the Trigeminal Nerve , Brain 62:41, 1939. 9. Lewy, F. H.: The Role of Cervical Nerves in Facial Sensation and the Quantitative Disturbance of Sensitivity in Major Trigeminal Neuralgia , Am. J. M. Sc. 196:509, 1938. 10. Wallenberg, A.: Anatomischer Befund in einem als Blutung in die rechte Brückenhälfte usw. aus dem Ram. central. arter. radicular N. facialis dextrius geschilderten Fälle , Deutsche Ztschr. f. Nervenh. 27:436, 1904. 11. Winkler, C.: De bouw van het zenuwsteelsel 2:26, 1920. 12. Cadwalader, W. B.: Thrombosis of the Right Posterior Inferior Cerebellar Artery Causing Bilateral Paralysis of Muscles of Deglutition , J. Nerv. & Ment. Dis. 41:375, 1914. 13. Müller, E.: Ueber ein eigenartiges scheinbar typisches Symptomenbild bei apoplectiformer Bulbarlähmung , Deutsche Ztschr. f. Nervenh. 31:452, 1906. 14. Breuer, R., and Marburg, O.: Zur Klinik und Pathologie der apoplectiformen Bulbärparalyse , Arb. a. d. neurol. Inst. a. d. Wien. Univ. 9:181, 1902. 15. Grant, F. C., and Weinberger, L. M.: Experiences with Intramedullary Tractotomy: IV. Surgery of the Brain Stem and Its Complications , Surg., Gynec. & Obst. 72:747, 1941. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

EXPERIENCES WITH INTRAMEDULLARY TRACTOTOMY: III. STUDIES IN SENSATION

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Publisher
American Medical Association
Copyright
Copyright © 1942 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1942.02290090011001
Publisher site
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Abstract

Abstract The new operation of intramedullary tractotomy (Sjöqvist) has reawakened an interest in the anatomic arrangement and physiologic functions of the fibers composing the descending tract of the trigeminal nerve. Current ideas on these matters have been derived largely from clinicopathologic observations in cases of thrombosis of the posterior inferior cerebellar artery and of syringobulbia in which the intramedullary trigeminal fibers were involved in the pathologic process. Lesions of this character, because of their irregular size and intensity of destruction, have obvious disadvantages when a study of the clinical effects relating to impairment of a single structure or of an isolated tract is desired. Surgical transection of the descending tract of the trigeminal nerve in man, performed by means of a small controlled incision into the tuberculum cinereum, obviates many of the former difficulties and allows for the first time correlation of sensory changes with a small lesion accurately placed in References 1. Grant, F. C.; Groff, R. A., and Lewy, F. H.: Section of the Descending Root of the Fifth Cranial Nerve , Arch. Neurol. & Psychiat. 43:498 ( (March) ) 1940. 2. von Frey, M.: Untersuchungen über die Sinnesfunktion der menschlichen Haut: I. Druckempfindung und Schmerz , Abhandl. d. math.-phys. Cl. d. k. Sachs. Gesellsch. d. Wissensch. 45:175, 1896. 3. Spiller, W. G.: Remarks on the Central Representation of Sensation , J. Nerv. & Ment. Dis. 42:399, 1915. 4. Stopford, J. S.: The Function of the Spinal Nucleus of the Trigeminal Nerve , J. Anat. 59:120, 1924. 5. Gerard, M. W.: Afferent Impulses of the Trigeminal Nerve, Intramedullary Course of Painful, Thermal and Tactile Impulses , Arch. Neurol. & Psychiat. 9: 306 ( (March) ) 1923. 6. Walker, E. A.: Anatomy, Physiology and Surgical Considerations of the Spinal Tract of the Trigeminal Nerve , J. Neurophysiol. 2:234, 1939. 7. Sjöqvist, O.: Studies on Pain Conduction in the Trigeminal Nerve , Acta psychiat. et neurol. , 1938, (supp. 17) . 8. Smyth, G. E.: The Systemization and Central Connections of the Trigeminal Nerve , Brain 62:41, 1939. 9. Lewy, F. H.: The Role of Cervical Nerves in Facial Sensation and the Quantitative Disturbance of Sensitivity in Major Trigeminal Neuralgia , Am. J. M. Sc. 196:509, 1938. 10. Wallenberg, A.: Anatomischer Befund in einem als Blutung in die rechte Brückenhälfte usw. aus dem Ram. central. arter. radicular N. facialis dextrius geschilderten Fälle , Deutsche Ztschr. f. Nervenh. 27:436, 1904. 11. Winkler, C.: De bouw van het zenuwsteelsel 2:26, 1920. 12. Cadwalader, W. B.: Thrombosis of the Right Posterior Inferior Cerebellar Artery Causing Bilateral Paralysis of Muscles of Deglutition , J. Nerv. & Ment. Dis. 41:375, 1914. 13. Müller, E.: Ueber ein eigenartiges scheinbar typisches Symptomenbild bei apoplectiformer Bulbarlähmung , Deutsche Ztschr. f. Nervenh. 31:452, 1906. 14. Breuer, R., and Marburg, O.: Zur Klinik und Pathologie der apoplectiformen Bulbärparalyse , Arb. a. d. neurol. Inst. a. d. Wien. Univ. 9:181, 1902. 15. Grant, F. C., and Weinberger, L. M.: Experiences with Intramedullary Tractotomy: IV. Surgery of the Brain Stem and Its Complications , Surg., Gynec. & Obst. 72:747, 1941.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Sep 1, 1942

References