Pneumaturia, with Report of a Case

To accomplish this it was necessary to follow each artery to its origin in the a. cerebri media.Between the substantia perforata anterior and the trunk of the a. cerebri media there is a tangled and confused mesh of pia mater and vessels, and in tracing one of these little arteries through this snarl without losing or breaking it, or destroying any of the adjacent and sometimes adherent vessels, is a tedious and difficult task.Had M. Duret and M. Charcot traced these vessels to their origins, they would not have written the following:" The predominant share of the circulation of the corpus striatum belongs to the sylvian artery which supplies : (1) the greater part of the caudate nucleus;(2) all of the lenticular nucleus; (3) a portion of the optic thalmus; (4) the whole extent of the internal capsule.The anterior cerebral, on the other hand, has a very unassuming position in this system.It furnishes twigs to the head of the caudate nucleus only and even this distri- bution is not constant."This statement regarding the relative importance of these two arteries is repeated throughout the writings of these authors and has been pre- served in anatomical textbooks.While one hesitates to dispute such well estab- lished authorities, the dissection of numerous brains made evident the need of modifying the statement when it was found that Group 1 had its origin in the a. cerebri anterior.The main artery of this group has its course in the a. cerebri anterior, directly opposite the a. comnninicans anterior.It starts backward on the superior surface of the a. cerebri anterior and is sometimes adherent to it, and is not visible unless the a. cerebri anterior is freed from it and drawn to one side.It can then readily be traced back to the bifurcation of the a. carotis interna where it takes an outward turn and follows the a.cerebri media and enters the tangle of the pia imiter and vessels that lie between the a. cerebri media and the substantia perforata anterior.This artery differs from the other arteries of the corpus striatum by giving off branches before it enters the substantia perforata anterior.As soon as it takes the outward turn at the bifur- cation of the a. carotis interna it sends a * " Est vir primarius hie Gothn\ qni collica per anum atlligitur, cum borborygmis, tensiono abdominis, doloribus circa umbilicum, ct quod pecuharc est flatus per penem quasi solemui et consueta tuue excernuntur via, saepe cum.