✓ The authors report a retrospective study of 146 patients to assess the extent to which aneurysms, arteriovenous malformations, and pregnancy interact. The natural history of the lesions was modified if the women became pregnant. Clinical syndromes, diagnosis, neurosurgical and obstetrical management, and treatment are discussed.
The authors report their experience with 124 cases of intracranial hemorrhage in children and adolescents; the study includes 25 cases first reported in 1958. Fifty aneurysms with a mortality rate of 28% and 33 arteriovenous malformations with a mortality rate of 21% are included; 32 cases had no angiographically demonstrable lesion, six had miscellaneous lesions, and three primary cerebral hemorrhage. Specific programs for therapeutic management based on this experience are discussed. KEY Woaosintracranial hemorrhage children congenital aneurysms arteriovenous malformations adolescents angiography].
✓ Three patients in whom pituitary tumor led to sudden blindness are described; in two, there had been no other indication of a pituitary neoplasm. The authors believe that observation of these patients for 24 hours after the onset of blindness has prognostic value and is safe. If visual improvement occurs during this time, the chances of useful recovery of vision are good. Further delay is contraindicated since in spite of visual improvement, these patients may show a general deterioration which may terminate fatally unless operation is performed.
✓ A case of congenital fistula between the posterior auricular artery and the transverse sinus is described. A comment is added on the possible embryological mechanism producing these lesions, and the usual symptomatology and treatment are discussed.
Proceedings of the Society of British Neurological Surgeons clinical states. It was demonstrated in polygraphic studies that the large plateau waves coincided with a reduction in local cortical blood flow and available oxygen. Clinical improvement after the administration of steroids was reflected in the record by the virtual disappearance of high pressure waves 12 hours after commencement of treatment. Similar records were obtained from patients with communicating hydrocephalus and 'benign intracranial hypertension'.Eleven cases of so-called normal pressure hydrocephalus were monitored. The majority had flat pressure recordings but a few showed levels above normal at certain periods. Operation was performed in eight patients, half of whom subsequently showed improvement in intellectual performance. Two of these cases had suffered a previous subarachnoid haemorrhage.The third group of cases were those with severe closed head injuries. Recordings were found to be particularly valuable where there was no evidence of an immediately remediable lesion since it was this group in which an insidious deterioration commonly occurred. On several occasions craniotomy had been undertaken because the recordings showed a rising ICP in the absence of clinical change. Examples were given in each group and the technical problems in relation to a fully reliable pressure transducer were described. RELATIONSHIP BETWEEN INTRACRANIAL PRESSURE AND WATER CONTENT OF THE BRAIN IN EXPERIMENTAL BRAIN OEDEMAJ. W. F. BEKS and H. P. M. KERCKHOFFS (Groningen) had produced experimental cerebral oedema in cats by the application of cold to a circumscribed area of cortex through the intact dura. Four groups of animals were described. Group A consisted of controls. No lesion was inflicted and hyperosmotic solutions were not administered.Group B were killed when, after infliction of the lesion, intraventricular pressure had increased by 500 mm H20 above its initial value. Hyperosmotic solutions were not administered.Group C. The same procedure was followed, but when intracranial pressure reached 500 mm H20 above its initial value a hyperosmotic urea solution was administered. The animals were killed at the lowest pressure subsequently achieved.Group D was the same as the preceding group, except for the substitution of a hyperosmotic mannitol solution for urea.The results of this investigation showed: 1. There was no increase in water content of the injured portion of cerebral cortex compared with the uninjured cortex.2. There was a significant increase in water content of the white matter underlying the injured cortex.3. There was no decrease in cortical water content after administration of hyperosmotic solutions.4. Dehydration of the abnormal white matter was more marked with urea than with mannitol.5. A close correlation between cerebral water content and increase of intracranial pressure was not found. SOME ASPECTS OF SUBARACHNOID HAEMORRHAGE IN PREGNANCYJ. L. ROBINSON and C. J. HALL (Liverpool) reviewed 26 cases of spontaneous subarachnoid haem...
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