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蛛网膜颗粒:丹迪是丹迪,库欣和威德不是。

Arachnoid granules: Dandy was Dandy, Cushing and Weed were not.

出版信息

Med Hypotheses. 2010 Aug;75(2):238-40. doi: 10.1016/j.mehy.2010.02.030. Epub 2010 Mar 17.

Abstract

Errors can be instructive. It seems that Harvey Cushing and Louis Weed provided the medical world with a faulty theory of cerebrospinal fluid absorption. Louis Weed, working in Harvey Cushing's laboratory, initially studied the movement of substances in the cerebrospinal fluid by using low-pressure studies. Results of the low-pressure studies were considered unsatisfactory and high pressure experiments were undertaken and these had results similar to earlier work done by others in human cadavers. High pressure results demonstrating movement of fluid through the arachnoid granules were deemed correct. Because of Cushing's position of authority, the theory became accepted as fact and in time proved to be entrenched dogma. Walter Dandy demonstrated in experiments on hydrocephalus and the surgical removal of the arachnoid granule system that the fluid was produced by the choroid plexuses and not absorbed by the arachnoid granules. His work was dismissed by Weed as unreliable. Examination of the pattern of deposition of corpora amylacea on the surface of the brain provides evidence that cerebrospinal fluid does not pass through arachnoid granules but passes through the choroid fissure and is recycled through choroid plexus portals. The choroid plexus portal theory can explain the findings in the low-pressure experiments of Weed. Bias and pride seem to be the source of the faulty theory. Entrenched dogma is resistant to challenge.

摘要

错误也可以是有益的。哈维·库欣(Harvey Cushing)和路易斯·威德(Louis Weed)似乎为医学界提供了一个错误的脑脊髓液吸收理论。路易斯·威德(Louis Weed)在哈维·库欣(Harvey Cushing)的实验室工作时,最初通过低压研究来研究脑脊髓液中物质的运动。低压研究的结果并不令人满意,因此进行了高压实验,这些实验的结果与其他人在人体尸体上所做的早期工作相似。通过蛛网膜颗粒的流体运动的高压实验结果被认为是正确的。由于库欣的权威地位,该理论被接受为事实,并且随着时间的推移,被证明是根深蒂固的教条。沃尔特·戴迪(Walter Dandy)在脑积水和蛛网膜颗粒系统的外科切除手术的实验中证明,液体是由脉络丛产生的,而不是由蛛网膜颗粒吸收的。威德(Weed)认为他的工作不可靠。对脑表面淀粉样体沉积模式的检查提供了证据,证明脑脊髓液不会通过蛛网膜颗粒,而是通过脉络裂循环,并通过脉络丛门进行再循环。脉络丛门理论可以解释威德的低压实验结果。偏见和骄傲似乎是错误理论的根源。根深蒂固的教条难以挑战。

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