Schizophrenia: A Very Short Introduction (Very Short Introductions) by Chris Frith & Eve C. Johnstone

Author:Chris Frith & Eve C. Johnstone
Language: eng
Format: mobi, epub
Publisher: Oxford University Press
Published: 2003-05-21T16:00:00+00:00

Investigation of the nervous system during life was not possible until 1919, when pneumoencephalography was introduced by the neurosurgeon Dandy. This technique involves removing some of cerebrospinal fluid from the spaces around the spinal cord and replacing it with air. The air rises up the spinal canal until it outlines the cerebral ventricles (the four natural cavities within the brain that are normally filled with cerebrospinal fluid, see Figure 15), so that these appear black on an X-ray picture. This technique was first applied to patients with schizophrenia in 1927 by Jacobi and Winkler, who claimed that 18 of 19 schizophrenic patients showed enlargement of the cerebral ventricles. A number of other early studies were carried out and most reached similar conclusions, although few used control subjects. Pneumoencephalography is an unpleasant procedure for the subject – it is usually associated with headache and vomiting, and just occasionally the changes in pressure inside the skull can have serious and even fatal consequences. Because of this, in 1929, the American radiological authorities declared that it was unethical to use normal controls in pneumoencephalographic investigations. This placed considerable limitations on subsequent studies, although some were carried out in Japan and in some other countries, and these also tend to support Jacobi and Winkler’s work.

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