STUDIES ON INTRACRANIAL PRESSURE

1. The results of this work form a confirmation of the earlier work of Cushing in all details investigated. 2. The increase of blood pressure that results from an increase of the intracranial pressure above the blood pressure is due in the dog to a vaso-constriction of the vessels of the intestine, the kidney and the limbs. Preceding this constriction there is dilatation. 3. The anastomotic connection between the internal carotid artery within the skull and the ophthalmic branch of the internal maxillary is of a size in the dog approximately equal to the internal carotid outside of the skull. The anatomical relations are such as to indicate that the internal maxillary artery in this animal is a cerebral artery equal in importance to the internal carotid. The anastomotic connection because of its position within the cranial cavity is unaffected except by extreme grades of intracranial compression. 4. The ordinary method of artificial perfusion of the dog's brain as used in physiological investigation appears from this work to be of no value, since there is at least one important path open besides that through the vessels of the brain. 5. The increase of the intracranial pressure above the blood pressure leads to a complete anæmia, superficial and deep, of the blood vessels of the brain. If the intracranial pressure is not greatly increased above the blood pressure, the circle of Willis and some of the larger arterial connections at the base of the brain are more or less well injected. An intracranial pressure somewhat below blood pressure leads apparently to a certain degree of anæmia directly beneath the point of entrance of the intracranial fluid; the condition of the rest of the brain as regards blood supply is normal.