NEUROSURGKRV— ROTTKRiaJ. and T,0UGHKKD 



367 



Fig. 5. — Arteriogram of same patient as in fig. 4, showing clip on neck of aneurysm. 



periods of cervical occltision of l)Oth common carotid and both vertebral arteries 

 ranged from two minutes to 13 minutes and 20 seconds, with repeated periods of 

 occlusion in some cases. There has been no c-linical evidence of cerebral dysfunc- 

 tion attributable to hypothermia or occlusion of the cerebral circulation save in the 

 case of ventricular filirillation. 



The liabilities inherent in the use of hypothermia, such as ventricular fibrillation, 

 must be weighted against the grave dangers to life from ruptured aneurysms and 

 their treatment. The results have encouraged us to pursue this methodology, but as 

 yet we do not have sufficient experience to warrant definite conclusions. The possi- 

 bility of operating upon lesions of cerebral blood vessels, supported by interruption 

 of cerebral circulation, may allow development of new and vital reparative opera- 

 tive procedures. 



REFERENCES 



1. Bigelovv, W. G., Lindsay, W. K., and Greenwood, W. F. : Hypothermia. Its possible role in 



cardiac surgery : An investigation of factors governing survival in dogs at low body 

 temperatures, Ann. Surg. 132: 849-866, 1950. 



2. Lougheed, W. M., and Kahn, D. S. : Circumvention of anoxia during arrest of cereliral cir- 



culation for intracranial surgery, J. Neurosurg. 12: 226-239, 1955. 



3. Botterell, E. H.. Lougheed. \V. ^L, Scott, J. \V., and Vandewater, S. L. : Hyix)thermia, and 



interruption of carotid, or carotid and vertebral circulation, in the surgical management 

 of intracranial aneurysms. J. Xeurosurg. 13: 1-42, 1956. 



4. Lougheed, W. M.. Sweet, W. H., White, J. C, and Brewster, \V. R. : The use of hypo- 



thermia in surgical treatment of cerebral vascular lesions, J. Xeurosurg. 12: 240-255. 1955. 



