Studies in intracranial physiology & surgery : the third circulation, the hypophysis, the gliomas / by Harvey Cushing.
- Harvey Williams Cushing
- Date:
- 1926
Licence: In copyright
Credit: Studies in intracranial physiology & surgery : the third circulation, the hypophysis, the gliomas / by Harvey Cushing. Source: Wellcome Collection.
32/168 page 16
![that the fluid was absorbed by the pial vessels, was not in accord. Moreover it fitted in with my preconceived idea that the cause of ‘ idiopathic ’ hydrocephalus would be disclosed when the portals of absorption were found. I therefore may be prejudiced in feeling that those who have subsequently written on the surgical aspects of hydro¬ cephalus [Dandy43 (1921), Fraser and Dott (1922)] have not sufficiently borne in mind in their classifications of hydro¬ cephalus the ease with which these microscopic villi may be occluded by the products of inflammation or by blood in the meningeal spaces, with the consequent reduction, either as an acute or chronic process, in the absorptive powers of these tiny but important structures through which the fluid normally escapes. Weed’s later demonstration36 of the ease and certainty with which a chronic hydrocephalus of high grade may be experimentally produced by the simple injection into the subarachnoid channels of lamp¬ black, which serves to occlude the arachnoid villi, would seem to make it most probable that damage or imperfect development of these structures is the most common cause of otherwise unexplained cases of early or congenital hydrocephalus. The perivascular channels. But to return to the views of others in regard to the process of absorption or drainage. In a study of the brains of animals subjected to experimental anaemia, Frederick W. Mott had observed that the peri¬ vascular c lymphatics ’ of Robin (better known to patholo¬ gists as the Virchow-Robin spaces) which represent pro¬ longations of the leptomeninges around the vessels that dip into the brain substance, were particularly well shown. These observations led him to conclude that absorption of the fluid from the subarachnoid spaces normally took place by way of these ‘ lymph ’ channels, with the natural corollary that the cerebral capillaries represented the chief absorbent](https://iiif.wellcomecollection.org/image/b29929209_0032.jp2/full/800%2C/0/default.jpg)
