1090 



SURGICAL ASD TOPOGRAPHICAL AXATOMY 



To find the fissure of Rolando the following methods have been emi)loyed. In 

 a given case it is well to enipk)y them all, so that any error in one may be checked 

 b}' another measurement: 



I. The upper and lower Rolandic points are found as above directed, and the 

 Rolandic line is drawn between them. 



II. The upper Rolandic point is taken two inches behind the bregma, or junction 

 of the coronal and sagittal sutures. The position of the lower end of the fissure is 

 thus determined: From the very end of the external orbital process, where this rises 

 up to join the temporal crest, draw a horizontal line two and a quarter inches long, 

 and from the extreme end of this draw a vertical line of a little over one inch. 

 Between these upper and lower Rolandic points, ])assing rather oljliquely forwards, 

 lies the fissure of Rolando (Lucas, Championniere). 



III. Here (1) the sagittal line is taken; (2) and (3) at a right angle to this 

 two lines are drawn vertically over the side of the skull, — the one starting from 

 the pre-auricular point (fig. 666), the other at the level of the posterior border of 

 the mastoid process, — and meeting the sagittal line about two inches behind the 

 second; (4) from the junction of the lines 1 and 3, one is drawn diagonally down- 



FiG. 666. — Craxio-cerebral Topography. (Anderson aud Makins.) 



■ SQUAMOSAL POINT 



Course of anterior divi- 

 sion of middle menin- 

 geal artery 



ROLANDIC FISSURE, LOWER 

 END 



Froiitdl branch of iiiid- 



il/f ini'tiiiu/fiil iirtfri/ 



COMMENCEMENT OF SYLVIAN 



FISSURE 



ANGULAR POINT 



GLABELLAR POINT 



ANTERIOR MENINGEAL 

 POINT 



MID-SAGITTAL POINT 

 ROLANDIC FISSURE, UPPER 

 END 



TERMINATION OF SYLVIAN 



FISSURE 

 TERMINAL ANGLE OF SYL- 

 VIAN FISSURE 

 LAMBDA AND EXTERNAL PA- 



RIETO-OCCIPITAL FISSURE 

 POSTERIOR MENINGEAL 

 POINT 



MASTOID ANTRUM 



Course of posterior division 

 of middle meningeal artery 



POINT OF BIFURCATION OF 

 SYLVIAN FISSURE 



PREAURICULAR POINT 



wards, reaching 2 about two inches above and a little in front of the external 

 auditory meatus (Reid and Godlee). 



I'- The fissure of Rolando may be found l)y the measurements given bv INIakins 

 and /\nderson (fig. 666). 



The external parieto-occipital fissures. — The upi)er end of this will a})pear 

 just in fr(.)nt of the lambda. 



Before leaving this subject, the attention of the student and surgeon is drawn to 

 fig. 666 and the method which it illustrates — that of Anderson and JNIakins. As 

 claimed by these surgeons and anatomists, their method fulfils the recjuirements of 

 any ])ractical scheme of cranio-cerebral topography, viz. : (1) The cranial landmarks 

 employed shall be distinct, and subject as little as possible to variations in rela- 

 tion to the general proportions of the skull-cap; (2) that the guiding lines, drawn 

 by the aid of these landmarks, shall ada|)t tlKMuselves to skulls of varying size and 

 conformation; and (3) that no special aj^paratus shall be rcipiired for the localisa- 

 tion. 



The method recommended by Anderson and ^Nlakins is the following: The 



