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Minim Invasive Neurosurg 2011; 54(05/06): 243-246
DOI: 10.1055/s-0031-1297249
Historical Article
© Georg Thieme Verlag KG Stuttgart · New York

“Colossal” Breakthrough: The Callosal Puncture as a Precursor to Third Ventriculostomy

D. A. Chesler
1   The Johns Hopkins University School of Medicine, Department of Neurosurgery and Oncology, Baltimore, MD, USA
2   The University of Maryland Medical Center, Department of Neurosurgery, Baltimore, MD, USA
,
C. Pendleton
1   The Johns Hopkins University School of Medicine, Department of Neurosurgery and Oncology, Baltimore, MD, USA
,
G. I. Jallo
1   The Johns Hopkins University School of Medicine, Department of Neurosurgery and Oncology, Baltimore, MD, USA
,
A. Quiñones-Hinojosa
1   The Johns Hopkins University School of Medicine, Department of Neurosurgery and Oncology, Baltimore, MD, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
25 January 2012 (online)

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Abstract

Background:

In 1908, Anton and von Bramann proposed the Balkenstich method, a corpus callosum puncture which created a communication between the ventricle and subarachnoid space. This method offered the benefit of providing continuous CSF diversion without the implantation of cannula or other shunting devices, yet it received only slight reference in the literature of the time. It remained a novel and perhaps underutilized approach at the time Cushing began expanding his neurosurgical practice at the Johns Hopkins Hospital.

Materials and Methods:

Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, the surgical records of the Johns Hopkins Hospital for the period 1896–1912 were reviewed. Patients operated upon by Harvey Cushing were selected.

Results:

7 patients underwent puncture of the corpus callosum for treatment of hydrocephalus. 6 patients were treated for obstructive hydrocephalus secondary to presumed intracranial lesions. 1 patient was treated for congenital hydrocephalus.

Conclusion:

The series reported here documents Cushing’s early use of the corpus callosum puncture to divert CSF in patients with obstructive hydrocephalus secondary to intracranial tumors, as well as an attempt to use the procedure in a pediatric patient with congenital hydrocephalus. Notably, 3 patients developed new onset left-sided weakness post-operatively, possibly due to retraction injury upon the supplementary motor intra-operative manipulations.

Key words

callosal puncture - cushing - hydrocephalus
 

  • References

  • 1 Davidoff L. Treatment of hydrocephalus: historical review and description of a new method. Arch Surg 1929; 18: 1737
    CrossrefPubMedGoogle Scholar
  • 2 Quincke H. Die lumbarpuncture des hydrocephalus. J Mol Med 1891; 28
    PubMedGoogle Scholar
  • 3 Payr . Drainage der Hirnventrikel Mittels Frei Transplantirten Blutgefassen. Zentralbl f Chir 1908;
    PubMedGoogle Scholar
  • 4 McClure RD. Hydrocephalus treated by drainage into a vein of the neck. Johns Hopkins Hosp Bull. 1909
    PubMedGoogle Scholar
  • 5 Fowler RS. The surgical treatment of internal hydrocephalus. Ann Surg 1909; 49: 374
    CrossrefPubMedGoogle Scholar
  • 6 Cushing H. Surgery of the Head. Philadelphia: W.B. Saunders Co; 1908
    Google Scholar
  • 7 Cushing H. The Third Circulation. In: Studies in Intracranial Physiology & Surgery. London: Oxford University Press; 1928
    Google Scholar
  • 8 Keen WW. Surgery of the Lateral Ventricles. Verhandlungen, des Zehnte Internatt Medicinischen Congress 1891
    PubMedGoogle Scholar
  • 9 Anton, Bramann v . Balkenstich bei Hydrozephalien, tumoren und bei Epilepsie. Medizinische Wochenschrift 1908; 55: 1673
    PubMedGoogle Scholar
  • 10 Archibald E. Puncture of the corpus callosum. Can Med Ass J 1913; 3: 451
    PubMedGoogle Scholar
  • 11 Mixter W. Ventriculoscopy and puncture of the floor of the third ventricle – preliminary report of a case. Boston Med Surj J 1923; 188: 277
    PubMedGoogle Scholar
  • 12 Dandy WE. An operative procedure for hydrocephalus. Johns Hopkins Hosp Bull 1922; 33: 189
    PubMedGoogle Scholar
  • 13 Elsberg CA. Puncture of the corpus callosum with special reference to its value as a decompressive measure. J Nervous Mental Dis 1915; 42: 140
    CrossrefPubMedGoogle Scholar
  • 14 Greenblatt SH. A History of Neurosurgery: In its Scientific and Professional Contexts. New York: Thieme; 1997: 625
    Google Scholar
  • 15 Wilkins RH, Wilkins GK. American Association of Neurological Surgeons . Neurosurgical classics II. [Park Ridge, Ill.]: American Association of Neurological Surgeons 2000; xii
    PubMedGoogle Scholar
  • 16 Magendie F. Recherches Physiologiques et Cliniques sur le Liquide Cephalo-Rachidien. Paris; 1842
    PubMedGoogle Scholar