A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . Chienes method of obtaiuiug an angleof 67% degrees for fixing position of Ro-landic fissure. (Keen and White.) 206 DISEASES AND INJURIES OF THE BRAIN. A convenient method of outlining the location of the central fissureis to mark the bregma, which lies vertically above the auditory meatus ;and to go 50 or 55 mm. below it and draw a line downwards and for-wards at an angle of 67 degrees. Chiene has devised a simple methodof obtai
A manual of modern surgery : an exposition of the accepted doctrines and approved operative procedures of the present time, for the use of students and practitioners . Chienes method of obtaiuiug an angleof 67% degrees for fixing position of Ro-landic fissure. (Keen and White.) 206 DISEASES AND INJURIES OF THE BRAIN. A convenient method of outlining the location of the central fissureis to mark the bregma, which lies vertically above the auditory meatus ;and to go 50 or 55 mm. below it and draw a line downwards and for-wards at an angle of 67 degrees. Chiene has devised a simple methodof obtaining an angle of 67^ degrees; this is sufficiently near to 67degrees. He takes a square of paper and folds it into two right-angletriangles, the smaller angles of these triangles must measure 45 de-grees, and half of one of these angles is 22 J degrees, which added to45 degrees equals 67J degrees. Fig. 82. 8 55 mm, AOE. Diagram showing one method of locating the fissure of Rolando. (Nancrede.) Some general rules may be formulated that are well worth atten-tion. In injury or disease in the neighborhood of the central fissure, whichis the motor region, operation is indicated when monoplegia is present,except when anaesthesia accompanies the paralysis of motion ; then itmay be contra-indicated, because the lesion is evidently so extensive thatsensory as well as motor centers are involved. When paralysis orconvulsive movements occur in connection with disease of the sensoryregion, operative interference may be improper, since the pathologicalchange is not limited to the sensory centers but involves the motorregion. An exploratory trephining, if properly carried out with anti-septic precautions, is so devoid of danger that many surgeons wouldoperate notwithstanding the coexistence of motor and sensory symptoms. Paralysis on the same side as the injury of the head should be con-sidered an indication agains
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