After reviewing the literature, a personal series of 10 adult patients with cerebellar infarction diagnosed by CT scan is described. The clinical picture in young adult men is characterized by rapid onset of headache, vomiting, vertigo, ataxia and blurred vision. After this sudden onset the patients may present a stable course or a rapid or delayed onset of brain stem compression, revealed by impairment of consciousness. CT scan is the diagnostic method of choice. The correlation between angiographic and CT localization of the infarction is not good. For therapy the following policy is suggested: in alert and clinically stable patients: medical treatment (mannitol, glycerol, dexamethason), ICP and serial CT monitoring; in alert patients with hydrocephalus or mass effect: medical treatment and monitoring as mentioned before; ventricular drainage if ICP surpasses 350 mm H2O; in patients with impaired consciousness and hydrocephalus or mass effect: immediate ventricular drainage. If it is not followed by prompt improvement of the level of consciousness, an emergency suboccipital craniectomy with removal of the infarcted tissue should be done.
A series of 88 patients, who underwent operation for intracranial haemorrhage, is reported. The outcomes are assessed in order to evaluate the operability in relation to the patient's age, the type of onset, the site of haemorrhage, the conscious level, the interval between accident and operation, cardiovascular disease and the dysmetabolic values. A numerical value has been assigned to each factor considered; than the correspondence between these values and the importance of each factor in relation to the clinical state has been analysed. The authors finally point out that their study, although it has a merely indicative significance, agrees sufficiently with the clinical results, as to give a useful pattern for a statistical approach to the question of intracerebral haemorrhage, offering in the meantime hopeful aids to diagnosis.
SummaryThe authors describe two cases in which computerized tomography (CT) revealed the presence of cervical intramedullary metastases in the form of increased density areas.
Diagnostic work-up and management of intracranial arachnoid cysts are still controversial. The authors have standardized a therapeutic protocol based on the information derived from CSF contrast flow studies. The report concerns 16 cases of intracranial arachnoid cysts treated according to their protocol.
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