Section of the Spinothalamic Tract at the Level of the Inferior Olive.

Schwartz, Henry Gerhard & O'Leary, James L.

Publication Date: 1942

About this Item

Arch. Neurol. Psychiat., 47. - Chicago, American Medical Association, February 1942, gr.8°, 12 pp., 7 Figs., orig. wrappers. Offprint! From the Departments of Surgery and Anatomy, Washington University School of Medicine. Schwartz and O'Leary in 1941 described the first section of the spinotha- lamic tract in the medulla oblongata at the junction of the middle and . *) "The literature concerning the pain pathways in the central nervous, system and their surgical interruption for the alleviation of pain has been extensively reviewed.* The present communication adds direct observations which concern the localization of the pain fibers from the body at the level of the inferior olive and confirmatory data on the course of the spinothalamic tract through the brain stem. The technical procedure of interrupting the spinothalamic tract in tin medulla, resulting in relief of high, intractable pain on the opposite side of the body, has been described in an earlier report.** On the basis of the sensory changes noted during the operation, it was concluded that a topical arrangement of fibers is present within the spinothalamic tract, so that at the level of the inferior olive fibers belonging to the lower dermatomes of the body lie more superficially while those of the upper ones occupy a more medial position. This arrangement is generally similar to that which has been reported previously for the spinothalamic fibers in the cord.3 We have had a second opportunity of performing intramedullary section of the spinothalamic tract for the relief of high, intractable pain and were again able to correlate sensory changes in different parts of the body with increasing depth of incision. After the operation, the patient was completely free of pain until her death from carcinoma, a month later. The length of the postoperative survival period permitted satisfactory studies of the brain by the Marchi method. This gave much additional information concerning the course of the fibers interrupted by the incision." Schwartz & O'Leary *) (a) Foerster, O., and Gagel, O.: Die Vorderseitenstrangdurchschneidung beim Menschen, Ztschr. f. d. ges. Neurol, u. Psychiat. 138:1-92, 1931. (6) Walker, A. E.: The Spinothalamic Tract in Man, Arch. Neurol. & Psychiat. 43:284-298 (Feb.) 1940. (c) Grant, F. C.: Surgical Methods for the Relief of Pain J A M. A. 116:567-571 (Feb. 15) 1941. **) Schwartz, H. G" and O'Leary, J. L.: Section of the Spinothalamic Tract in the Medulla with Observations on the Pathway for Pain, Surgery 9:183-193, 1941. See- Robert L. Grubb Jr.: Obituary: Henry G. (Gerard) Schwartz, M.D. 1909-1998. An obituary JNS 90 (1999): pp.599-602 W.M. Landau: James L. O'Leary, Ph.D., M.D. (1904-1975). J Neurol Sci., 28/2 (1976): pp. 255-257.

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Bibliographic Details

• Title: Section of the Spinothalamic Tract at the Level of the Inferior Olive.
• Publication Date: 1942
• Binding: Soft cover
• Seller catalogs:
  • Chirurgie