PDF herunterladen
CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2020; 78(03): 176-178
DOI: 10.1590/0004-282X20190142
Historical Note

Pioneers in the cisterna magna puncture

Pioneiros na punção da cisterna magna
Thiago Ferreira Simões DE SOUZA 
1   Hospital da Cruz Vermelha Brasileira, Departamento de Neurologia, Curitiba PR, Brazil.
› Institutsangaben
› Weitere Informationen
Auch verfügbar auf
   Lizenzen und Reprints

Abstract

At the beginning of the 20th century, cerebrospinal fluid (CSF) collection and analysis emerged as a promising aid in the diagnosis of diseases of the central nervous system. It was obtained through the established procedure of lumbar puncture, described by Heinrich Quinke in 1891. The search for an alternative way to gather the CSF emerged in animal research, highlighting the cisterna magna as a promising source, with relative safety when performed by someone trained. Described initially and in detail by James Ayer in 1920, the procedure was widely adopted by neurologists and psychiatrists at the time, featuring its multiple advantages and clinical applications. After a period of great procedure use and exponential data collection, its complications and risks relegated the puncture of the cisterna magna as an alternative route that causes fear and fascination in modern Neurology.

Resumo

No início do século XX, a coleta e análise do líquido cefalorraquidiano (LCR) despontavam como um promissor auxílio no diagnóstico das doenças do sistema nervoso central. Sua obtenção se dava através do consagrado procedimento de punção lombar, descrito por Heinrich Quinke em 1891. A busca por uma via alternativa na obtenção do LCR ganhou destaque nas pesquisas animais, destacando-se na cisterna magna promissora fonte, com relativa segurança quando executada por alguém treinado. Descrito inicialmente e de maneira pormenorizada por James Ayer em 1920, o procedimento foi amplamente adotado por neurologistas e psiquiatras à época, com destaque para suas múltiplas vantagens e aplicações clínicas. Após um período de grande uso do procedimento e exponencial obtenção de dados, suas complicações e riscos relegaram a punção da cisterna magna como via alternativa que causa medo e fascínio na Neurologia moderna.

Keywords:

cisterna magna - puncture - history of medicine - cerebrospinal fluid - suboccipital

Palavras-chave:

cisterna magna - punção - história da medicina - líquor - suboccipital


Publikationsverlauf

Eingereicht: 19. Juni 2019

Angenommen: 10. Juli 2019

Artikel online veröffentlicht:
02. Juni 2023

© 2020. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

 

  • References

  • 1 Quincke HI. Die Lumbarpunktion des Hydrocephalus. Berlin Klin Wschr. 1891;28:929-965.
  • 2 Olukoga AO, Bolodeoku J, Donaldson D. Cerebrospinal fluid analysis in clinical diagnosis. J Clin Pathol. 1997 Mar;50(3):187-92. https://doi.org/10.1136/jcp.50.3.187
  • 3 Westenhofer M. Zur Geschichte der Okzipitalinzision und Punktion. Munchen med Wchnschr. 1924;71:687.
  • 4 Obregia A. La rachicenthesis sous-occipitale. Compt Rend Soc Biol. 1908;65:277.
  • 5 Denny-Brown D, Viets H, Adams R, Schwab R, Kubik C, Smith R. James Bourne Ayer, MD 1882-1963. Arch Neurol. 1964 Oct;11(4):449-51. https://doi.org/10.1001/archneur.1964.00460220111015
  • 6 Ayer JB. Puncture of the Cisterna Magna. Arch NeurPsych.1920 Nov;4(5):529-41. https://doi.org/10.1001/archneurpsyc.1920.02180230052005
  • 7 Ayer JB. Puncture of the Cisterna Magna, Report of One Thousand, Nine Hundred and Eighty-Five Punctures. JAMA. 1923 Aug;81(5):358-60. https://doi.org/10.1001/jama.1923.02650050012004
  • 8 Spiegel L. The Technic of Cistern Puncture (Cisterna Magna). Arch Derm Syphilol. 1928 Sep;18(3):420-2. https://doi.org/10.1001/archderm.1928.02380150086011
  • 9 Eskuchen K. Die Lumbalpunktion. München-Schwabing. Berlin and Viena: Urban and Schwarzenberg; 1919.
  • 10 Eskuchen, K. Die Punktion der Cisterna Cerebello-medullaris (Technik experimentelle und klinische Verwendung). Klin Wchnschr. 1923 Oct;2(40):1830-3. https://doi.org/10.1007/BF01716646
  • 11 Loebe FM. Karl Eskuchen: A nearly forgotten pioneer in cerebrospinal fluid research. Psychiatr Neurol Med Psychol (Leipz). 1983 Sep;35(9):561-5.
  • 12 Loebe FM. History and significance of suboccipital puncture. Psychiatr Neurol Med Psychol (Leipz). 1988 Oct;40(10):617-20.
  • 13 Nonne MG. Meine Erfahrungen uber den Subokzipitalstich auf der Basis von 310 Fallen. Med Kln. 1924;20:919-922.
  • 14 Saunders HC, Riordan TJ. Cisternal or Suboccipital Puncture. N Engl J Med. 1929 Jul;201(4):66-168. https://doi.org/10.1056/nejm192907252010406
  • 15 Vonderahe AR, Haberman FC. Injury of Medulla in Puncture of Cisterna Magna. Arch NeurPsych. 1933 Jan;29(1):166-7. https://doi.org/10.1001/archneurpsyc.1933.02240070172013
  • 16 Kehrer HE. Uber Zwischenfiille bei der Suboccipitalpunktion. Deutsche Ztschr Nervenh. 1949;161:98-110.
  • 17 Winn WA. The Treatment of Coccidioidal Meningitis - The use of Amphotericin B in a Group of 25 Patients. Calif Med. 1964 Aug;101(2):78-89.
  • 18 Keane JR. Cisternal puncture complications - Treatment of coccidioidal meningitis with amphotericin B. Calif Med. 1973 Sep;119(3):10-5.