After the right ventricle has been opened the corpus callosum and
fornix are raised by the thumb and index-finger of the left hand,
putting the septum pellucidum on the stretch. The narrow brain-knife
is then introduced through the interventricular foramen from the
right, its blade flat, with cutting edge directed forward and upward,
and the fornix and the corpus callosum are cut anteriorly, exposing
the cavity of the septum pellucidum. To expose the third ventricle,
the corpus callosum, septum pellucidum and fornix are then lifted up
and laid back from the velum chorioides. The tela chorioidea is then,
with the chorioid plexus of the third ventricle, pulled backward from
over the pineal body and the corpora quadrigemina, care being taken
not to tear away the pineal body. The veins entering the tela from
the great ganglia are cut with the point of the knife. The right
descending posterior pillar or crus of the fornix is then lifted with
the thumb and index-finger of the left hand, the brain-knife on the
flat side with cutting edge to the right is introduced beneath it,
and the crus is cut toward the right. The corpus callosum, fornix and
tela are then turned over to the left (see Fig. 29), fully exposing
the pineal body and the corpora quadrigemina.
The cerebellum and medulla are now supported by the index-finger
of the left hand placed beneath the latter; while the brain-knife
is held nearly horizontally in the right, and a deep sagittal cut
is made into the vermis exactly in the median line so as to make
a small opening into the fourth ventricle. The point of the knife
with cutting edge upward is then introduced into this opening and
the incision through the vermis increased anteriorly and posteriorly
until the two cerebellar hemispheres fall apart and the fourth
ventricle is wholly opened. The point of the knife, with cutting
edge upward may then be introduced into the posterior opening of the
aqueduct and the latter opened to the third ventricle, the pineal
body being removed before the cut through the roof of the aqueduct
is made. In the Virchow method the corpora quadrigemina and the
vermiform portion of the cerebellum are sectioned in the median line
by a cut opening up both aqueduct and the fourth ventricle. Other
prosectors open the aqueduct from the third ventricle toward the
fourth. The left cerebellar hemisphere is now cut through in the line
of the middle branch of the arbor vitæ, exposing the dentate nucleus.
Each half of the hemisphere is again bisected by a cut made at right
angles to the surfaces exposed by the first cut. The right cerebellar
hemisphere is then similarly sectioned.
Public-domain text, read in full here on John Shaqi.
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