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완전 대뇌반구적출에 관한 실험적 연구 : An Experimental Study of Total Hemispherectomy in the Cat

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Authors

최길수; 심보성

Issue Date
1967-06-01
Publisher
서울대학교 의과대학
Citation
Seoul J Med, Vol.8 No.2, pp. 9-17
Abstract
Cerebral hemispherectomy, since its first application
by Dandy (1928), has been a radical procedure applied
to patients with infiltrating gliomas of one cerebral
hemisphere, intractable convulsive seizures due to
unilateral cerebral atrophy, Sturge-Weber syndrome or
diffuse cerebral paragonimiasis. In these operations the
caudate nucleus, thalamus and subthalamic structures
have usually been spared.
Although many fundamental contributions have been
made in the field of experimental neurology through
study of animals in which large portions of cerebrum
had been removed or destroyed, few experiments have
been performed to define the limit of [cerebral resection
compatible with maintenance of consciousness and survival.
The purpose of this study is to present the physiological
and anatomical observations on the effect of total
cerebral hemispherectomy in the cat. In this study,
twenty healthy cats of both sexes weighing five to nine
lbs. were subjected to one stage removal of all cerebral
cortex, basal ganglia, and thalamus from one side of the
brain. In ten cats total hemispherectomy was performed
on the right side and in the other ten on the left.
These experimental animals were clinically observed
for periods varying from five to thirty eight days. All
twenty cats that had total hemispherectomy survived the
initial operative procedure, but five of these cats
subsequently died within a week due to intracranial
hemorrhage or infection. Five of the surviving fifteen
cats were sacrificed within the fourteenth postoperative
day and the other ten were sacrificed during the period
from three to five weeks postoperatively. The brain
stem and spinal cord was stained with the Marchi
staining method to observe secondary degenerative changes
of nerve fibers.
The postoperative physiological findings were as
follows: In spite of the extensive removal of the
unilateral cerebrum including the thalamus, .all of these
animals demonstrated early and rapid return of consciousness,
giving evidence of awareness of environment
by noting objects in their remaining homonymous visual'
field.
After recovery from anesthesia, the totally hemispherectornized
cats demonstrated marked flaccid paralysis.
of contralateral extremities but good motor function on
the ipsilateral side. The contralateral flaccid paralysis
recovered slightly in the forelimb on the second postoperative
day and hindlimb improvement began on the third
postoperative day. Although the cats usually could get up
and walk within a few days and showed aJrrost ncrmal
motor function within a week, the distal musculature of
the contralateral extremities showed the least recovery.
Following unilateral total hemispherectomy including the
thalamus, these experimental animals were unable to
respond to painful stimuli on the contralateral side when
they awoke from anesthesia. However, painful stimulation
was perceived over the contralateral face and extremities
in twenty four hours, and maximum return of sensory
function was accomplished by the third postoperative
day.
ISSN
0582-6802
Language
Korean
URI
https://hdl.handle.net/10371/8209
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