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April 1929


Author Affiliations

From the Surgical Clinic of Dr. Harvey Cushing, the Peter Bent Brigham Hospital, Boston.

Arch Surg. 1929;18(4):1646-1658. doi:10.1001/archsurg.1929.01140130746049

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

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