脳外科方面

HEADACHE IN NEUROSURGERY

緒言

　頭痛の起り方については，今日Wolffの説が広く行われているようである。これは脳手術の際の痛覚検査を基礎とするものであるが，それについて，私には多少異論もあるので，今日はその点を中心として述べたいと思う。

1) By reviewing our operation records at the former time, when intracranial operations were routinely done under local anesthesia merely of the scalp, it was found that pains were induced quite infrequently by the man-ipulation of intracranial vessels except mid-dle meningeal artery of the dura.

2) In our experiences of more than 500 cases of brain tumors it seems quite likely that the main source of the brain tumor headache may be the dura rather than intracranial large vessels.

3) Pulsating headache resulting presumably from dilatation of pial or cerebral arteries with increased pulsation is encountered rather frequently in intracranial diseases without much elevation of intracranial pressure, whereas such a pulsating vascular pain is quite uncommon in diseases of the visceral organs other than the brain. Thus the pulsating vascular pain may be characteristicof intracranial arteries.