The section of the brain now shows all of the ventricles and their
relations, as well as the condition of a large part of cerebral
and cerebellar brain-substance. (See Fig. 29.) All cut portions
are connected with each other and it is possible to fix the entire
brain as it now stands and later find no difficulty in topographic
orientation. There still remains, however, the demonstration of the
conditions in the basal ganglia, pons, medulla, etc. These structures
are best shown by transverse cuts made across the entire brain as
it lies after the opening of the ventricles. The hemispheres may be
cut singly, but it is better to cut both of them at the same time,
using a dry blade and drawing the knife from left to right, making
identical cuts on the two sides, that the histologic features may
be compared. The transverse cuts may be made in the same region as
recommended in the method of Pitres (see below), or they may be made
closer together. As the cuts are made the sections are separated from
each other by the knife-blade and the cut surfaces examined. After
the cerebrum has been cut transversely in this way the peduncles,
pons, medulla and cervical cord are elevated on the index-finger of
the left hand and also sectioned transversely and the cut surfaces
examined. If the index-finger be placed beneath the medulla parallel
with its long axis, and medulla and pons raised up the cerebellar
lobes fall to the side out of the way. All transverse cuts are
made from left to right and so deep that only a small portion of
brain-tissue, or the basal meninges hold the parts together for
future orientation. The brain is now completely sectioned, with
all parts preserved and capable of being restored to their normal
relations. The parts may be re-assembled and the entire brain put
into the fixing fluid, when it is desirable to save the entire organ
for microscopic study.
[Illustration: FIG. 30.—Method of Pitres. _1, Sectio præ-frontalis_;
_2, Sectio pediculo-frontalis_; _3, Sectio frontalis_: _4,
Sectio parietalis_; _5, Sectio pediculo-parietalis_: _6, Sectio
occipitalis._]
=Other Methods of Opening Brain.= For the demonstration of large
localized pathologic conditions the brain may be opened by a
very simple method of transverse or sagittal incisions extending
entirely through the organ. The broad-bladed brain-knife should
be used and the blade should be wet. The cuts should be made
symmetrically on the two sides and with due reference to anatomic
landmarks. They may be made either from the convexity or from the
basal side.
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