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December 1950

BRAIN REVASCULARIZATION AFTER CAROTID-JUGULAR ANASTOMOSIS ASSESSED BY ANGIOGRAPHY

Author Affiliations

NEW YORK; BROOKLYN; NEW YORK

From the Departments of Neurosurgery, Radiology, Surgery and Pediatrics of the Jewish Hospital of Brooklyn.

AMA Arch NeurPsych. 1950;64(6):847-860. doi:10.1001/archneurpsyc.1950.02310300094009
Abstract

BECK, McKhann and Belnap1 made a noteworthy attempt to increase the vascularization of the brain in patients with mental retardation, convulsive disorders and various types of sensory and motor defects. These investigators established an arteriovenous fistula between the common carotid artery and the internal jugular vein, thereby converting the vein into an arterial channel. They chose the right side for the anastomosis, because a colored mixture injected into the right internal jugular vein in cadavers "filled the superior sagittal sinus and all of its visible branches." They concluded:

... The right jugular vein drains the cerebral cortex and that [blood] reaching the left jugular comes from the deeper portions and cerebellum.... Operation upon the right side would contribute the majority of blood to the cortex and also significant amounts to the deep circulation.

They operated on 11 patients and reported their results in four, stating that "although the postoperative follow-up

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