Abstract An active neurosurgical clinic in which tumors of the brain are removed daily provides an unusual opportunity to observe the effects of transfusion in patients urgently in need of blood. In the majority of these patients there is no complicating factor, i.e., no traumatic shock, sepsis, primary cardiac or vascular disease; in other words, the body is, in most instances, essentially normal except for the presence of the tumor. Exploratory operations and the partial, subtotal or complete removal of several types of tumors are, as a rule, accompanied by little loss of blood. Examples are operations on the gliomas, pituitary adenomas and the usual cerebellar tumors. Cerebral explorations without the removal of tumor, decompressions, ganglionectomies and the removal of old clot in pachymeningitis hemorrhagica interna are not exsanguinating operations. In sharp contrast to these relatively bloodless procedures lie the radical extirpations of meningiomas and hemangiomas, particularly the more extensive operations References 1. Cushing, Harvey: Macewen Memorial Lecture on the Meningiomas Arising from the Olfactory Groove and Their Removal by the Aid of Electro-Surgery , Lancet 1:1329 ( (June 25) ) 1927. 2. The pressure, of course, does not reach zero. However, it becomes too low to be detectable with the clinical sphygmomanometer. Throughout the paper, references to "zero" pressure should be so interpreted. 3. Davis, Loyal E., and Cushing, Harvey: Experiences with Blood Replacement During or After Major Intracranial Operations , Surg. Gynec. Obst. 40:310, 1925. 4. Blalock, Alfred: Mechanism and Treatment of Experimental Shock: I. Shock Following Hemorrhage , Arch. Surg. 15:762 ( (Nov.) ) 1927.Crossref 5. Barcroft, J.; Harris, H. A.; Orahovats, D., and Weiss, R.: A Contribution to the Physiology of the Spleen , J. Physiol. 60:443, 1925. 6. McLeod, J. J. R.: Physiology and Biochemistry in Modern Medicine , ed. 4, St. Louis, C. V. Mosby Company, 1922, p. 142. 7. Drinker, Cecil K.: Personal communication to the authors.
Archives of Surgery – American Medical Association
Published: Apr 1, 1929