Neurosurgical Considerations on the Brain Mechanisms of Consciousness

  • K. Kristiansen


In clinical neurosurgery consciousness and the different aspects of disturbed consciousness accompanying injuries and diseases of the brain, are of paramount significance. Unconsciousness is the most important symptom associated with injuries to the head, and is the central factor in the concussion syndrome. The change in the state of consciousness in patients with acute cranio-cerebral trauma is the only reliable clinical sign upon which depends the question of indications for surgical intervention. But also in less fulminant lesions the vigilance of the neurosurgical staff is concentrated upon disturbances of consciousness, ranging from the hardly perceptible but diagnostically significant alterations to the most extreme aberrations from the normal awareness in the waking state.


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  1. Berczeller, A., and K. Nowotny, Über Hirnerschütterung und Zustandsbilder nach Erhängungsversuchen. Mitt. Grenzgeb. Med. Chir., Jena, 44 (1935–1937), 100–118.Google Scholar
  2. Bergson, H., Essai sur les données immédiates de la conscience. 21. Ed. Librairie Félix Alcan, Paris, 1921.Google Scholar
  3. Breslauer, F., Hirndruck und Schädeltrauma. Mitt. Grenzgeb. Med. Chir., Jena, 29 (1917), 715–751.Google Scholar
  4. Breslauer, F., Die Pathogenese des Hirndrucks. Mitt. Grenzgeb. Med. Chir., Jena, 30 (1918), 615–640.Google Scholar
  5. Cairns, H., R. C. Oldfield, J. B. Pennybacker and D. Whitteridge, Akinetic mutism with epidermoid cyst of third ventricle (with report on associated disturbance of brain potentials). Brain, London, 64 (1941), 273–290.CrossRefGoogle Scholar
  6. Cobb, S., On the nature and locus of mind. Amer. Med. Ass. Arch. Neurol Psychiatr. 67 (1952), 172–177.CrossRefGoogle Scholar
  7. Dandy, W., The location of the conscious center in the brain the corpus striatum. Bull. Johns Hopkins Hosp. 79 (1946), 34–58.PubMedGoogle Scholar
  8. Delafresna ye, J. F., Brain Mechanisms and Consciousness. Blackwell Scientific Publications, Oxford, 1954.Google Scholar
  9. Dempsey, E. W., and R. S. Morison, The interaction of certain spontaneous and induced cortical potentials. Amer. J. Physiol. 135 (1942), 301–308.Google Scholar
  10. Denny-Brown, D., and W. R. Russell, Experimental cerebral concussion. Brain, London, 64 (1941), 93–164.CrossRefGoogle Scholar
  11. Dott, N. M., Brain, movement and time. Brit. Med. J. 11 (1960), 12–16.Google Scholar
  12. Ethelberg, S., On Changes in Circulation through the Anterior Cerebral Artery. Acta psychiatr. neurol., K’hvn, Suppl. 75, 1951.Google Scholar
  13. Fulton, J. F., and P. Bailey, Tumors in region of third ventricle, their diagnosis and relation to pathological sleep. J. Nerv. Ment. Dis. 69 (1929), 1–25, 145–164, 261–277.Google Scholar
  14. Hallervorden, J., Hirnerschütterung und Thixotropie. Zbl. Neurochir. 6 (1941), 37–42.Google Scholar
  15. Holbourn, A. H. S., Mechanics of head injuries. Lancet 11 (1943), 438–441.CrossRefGoogle Scholar
  16. James, W., Textbook of Psychology. Macmillan, London, 1892.Google Scholar
  17. Jasper, H., Diffuse projection systems. The integrative action of the thalamic reticular system. Electroencephalogr. 1 (1949), 405–420.CrossRefGoogle Scholar
  18. Jefferson, G., Selected Papers. Pitman Medical Publishing Co., Ltd., London, 1960.Google Scholar
  19. Kaada, B. R., W. Harkmark and O. Stokke, Deep coma associated with desynchronization in EEG. Electroencephalogr. 13 (1961), 785–789.CrossRefGoogle Scholar
  20. Knauer, A., and E. Enderlen, Die pathologische Physiologie der Hirnerschütterung nebst Bemerkungen über verwandte Zustände. J. Psychol., Leipzig, 29 (1922), 1–54.Google Scholar
  21. Knoflach, J. G., and R. Scholl, Klinik und Prognose der stumpfen Schädelverletzungen. Arch. klin. Chir., Berlin, 190 (1937), 452–522.Google Scholar
  22. Kocher, T., Hirnerschütterung, Hirndruck und chirurgische Eingriffe bei Hirnkrankheiten. In: Nothnagel, H., Spezielle Pathologie und Therapie. A. Holder, Wien, 1901.Google Scholar
  23. Kristiansen, K., Neurological investigations of patients with acute injuries of the head. Skr. utg. av Det Norske Videnskaps-Akademi i Oslo, I. Mat.-Naturv. klasse. Oslo, 1949.Google Scholar
  24. Lindsley, D. B., Psychological Aspects of Consciousness. In: Clin. Neurosurg., Vol. III, pp. 175–186. Proceedings of the Congress of Neurological Surgeons. Los Angeles, California, 1955. The Williams and Wilkins Company, Baltimore, 1957.Google Scholar
  25. Littré, A., Diverses observations anatomiques. Histoire de l’Académie royale des Sciences. pp. 54–55, Paris, 1705.Google Scholar
  26. Loeb, C., and G. Poggio, Electroencephalograms in a case with pontomesencephalic haemorrhage. Electroencephalogr. 5 (1953), 295–296.CrossRefGoogle Scholar
  27. Lundervold, A., T. Hauge and A. C. Leken, Unusual EEG in unconscious patient with brain stem atrophy. Electroencephalogr. 8 (1956), 665–670.CrossRefGoogle Scholar
  28. Marburg, O., Die traumatischen Erkrankungen des Gehirns und Rückenmarks. In: Bumke, O., und O. Foerster, Hdb. d. Neurol., XI, 1–177. Springer, Berlin, 1936.Google Scholar
  29. Meixner, K., Die Rolle der Gehirnerschütterung bei den tödlichen Schädelverletzungen. Dtsch. Zschr. gerichtl. Med. 6 (1926), 105–120.Google Scholar
  30. Mollaret, P., and M. Goulon, Le coma dépassé. Rev. neurol., Paris, 101 (1959), 3–15.Google Scholar
  31. Moruzzi, G., and H.W. Magoun, Brain stem reticular formation and activation of the EEG. Electroencephalogr. 1 (1949), 455–473.CrossRefGoogle Scholar
  32. Neuburger, K., and A. v. Braunmühl, Hirnverletzungen. In: Bumke, O., Hdb. d. Geisteskrkh. XI, 321–348. Springer, Berlin, 1930.Google Scholar
  33. Penfield, W., Consciousness and centrencephalic organization. Premier Congrès International des Sciences Neurologiques. Bruxelles, 21—28 Juillet 1957. (2e Journée Commune, pages 7–18.)Google Scholar
  34. Penfield, W., The Excitable Cortex in Conscious Man. Liverpool University Press, Liverpool, 1958.Google Scholar
  35. Rowbotham, G. F., Acute Injuries of the Head. 2. Edit., E. and S. Livingstone Ltd., Edinburgh, 1945.Google Scholar
  36. Tokuoka, S., H. Aoki, K. Higashi and K. Tatebayashi, Cooling irrigation of cerebral ventricular system. Second Internat. Congr. Neurol. Surg., Washington, D. C., Oct. 14–20, 1961. Excerpta Med., Internat. Congress Series, No. 36, pp. E. 148–149.Google Scholar

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© Springer-Verlag Wien 1964

Authors and Affiliations

  • K. Kristiansen
    • 1
  1. 1.Department of NeurosurgeryUllevål HospitalOsloNorway

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