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March 1939

LIGATION OF THE LEFT ANTERIOR CEREBRAL ARTERY: ITS HAZARDS AND MEANS OF AVOIDANCE OF ITS COMPLICATIONS

Author Affiliations

BOSTON

From the neurosurgical service of the Lahey Clinic and from the New England Baptist and the New England Deaconess Hospital.

Arch NeurPsych. 1939;41(3):495-503. doi:10.1001/archneurpsyc.1939.02270150069006
Abstract

It is fairly well known among neurosurgeons that ligation of the left anterior cerebral artery is hazardous and may be followed by disastrous results. Dandy1 emphasized this fact and has described a rather striking clinical picture observed after ligation of this artery. He said: "If the left anterior cerebral artery is injured by any chance the patient can never regain consciousness." He had personal experience with 2 patients who lived two and three weeks, respectively, after the artery had been ligated 2.5 cm. distal to the genu corporis callosi. His deduction was that the center of consciousness is located in the left cerebral hemisphere, in the region supplied by the left anterior cerebral artery; in other words, along the mesial aspect of the left cerebral hemisphere, near the anterior portion of the corpus callosum.

That this striking clinical picture of a permanent state of unconsciousness may be produced by

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