Decerebrate rigidity, intracranial pressure and vegetative signs were studied in 25 patients. Advanced statistical techniques were used to analyse the interrelationships between muscle activity (IEMG), blood pressure (ABP), intracranial pressure (ICP), pulse rate (HR), respiratory rate (RR), and central venous pressure (CVP) occurring during paroxysms of decerebration. The pattern of reaction is influenced by compression or stress imposed on the brain stem at the tentorial incisure and is related to the degree of cisternal obstruction. Significant differences in reaction were disclosed between provoked and spontaneous decerebration posturing.
The authors present a series of 25 cases of haemangioma of the skull and review the literature. Frontal localization was the most frequent, contrary to the data in the literature which suggest predominance in the parietal region. The reported predominance of females has not been confirmed. In the present series the relation of males to females was 17:8. The radiological findings and treatment of haemangiomas are discussed. Direct puncture and injection of contrast medium is the best method of visualization of the tumour. Treatment should be surgical, consisting of total extirpation of the tumour with a margin of healthy tissue. Simple extirpation is indicated only when the soft tissues are involved and there is no bone lesion. Excision en bloc is the tehcnique of choice.
The normal variations in the size of the ventricular systems was determined on technically satisfactory computer tomograms in 275 patients who were psychologically and neurologically normal. Ages range from one to 80 years and the data classified in decades. A physiological increase in the width of the ventricular system was found after the 50th year. The normal patients, who acted as a control group, were compared with 65 alcoholics. A significant increase in size (simple variance) was found in alcoholics after the fourth decade, as compared with normals. Correlation between the width of the ventricular system and cerebral function, and between liver damage and the ventricular system could not be established.
Since the introduction of CT, the assessment of ventricular enlargement and follow-up examinations after shunt surgery have become easier. By means of CT coronary and sagittal reconstructions as well as nuclearmagnetic resonance, the pathologic-anatomic changes in malformations with Arnold-Chiari II deformity and Dandy-Walker syndrome are clearly demonstrated. With nuclear magnetic resonance the morphology of structures in the posterior cranial fossa are demonstrated three-dimensionally, and in comparison with CT the method has the advantage that it involves no exposure to radiation. On the other hand, dynamic conditions of the CSF circulation can be evaluated better on the computerized tomogram following intrathecal injection of contrast medium. On the basis of our experience we believe that the different methods are complementary and can often be combined when planning surgery.
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