No abstract

Eighty-six patients with brain abscesses were seen at the University of Minnesota Hospitals from 1946-1965, and 46 died, a 53% mortality. Multiple and brain stem abscesses accounted for several fatalities, while delayed and missed diagnosis accounted for one third of the deaths. Evidence of infection was often minimal in patients with brain abscess. Lumbar puncture as a diagnostic tool was inaccurate and occasionally fatal. Brain scan, electroencephalography, and angiography were the best diagnostic tests. Drainage and excision were each associated with approximately a 20% mortality. The most pertinent correlation regarding treatment, however, was that of increasing mortality with deteriorating preoperative neurological status. Postoperative deaths were due to failure in locating the abscess at surgery or untoward events such as cerebritis, edema, or excessive bleeding at the operative site.KEY WORD brain abscess E

This report presents 18 cases of lipoma of the spinal cord or cauda equina, four of which were unassociated with congenital anomalies of the spine and 14 with such anomalies. Review of the literature shows that unassociated cases are rare, with only 100 cases reported, while those associated with congenital anomalies are more common. The patients ranged in age from 2 months to 5 years. Fourteen patients had external evidence of an abnormality in the form of a mass or dimple over the vertebral column. Plain x-ray films showed evidence of an intraspinal lesion in all cases except one. The treatment was surgical in all cases, with nine good results, eight satisfactory, and one unsatisfactory. The exact pathogenesis of spinal cord lipomas is unclear, although the high incidence of associated congenital defects, age of onset, and location of the tumors suggest a developmental origin. The tumors occupy a juxtamedullary-subpial location and are composed of firm, lobulated adult fat. Early surgery consisting of generous laminectomy, incision of the pia, and subtotal removal of the tumor is felt to be the treatment of choice. KEYWoRDs spinal cord tumor lipoma spina bifida eauda equlna tumor corns tumor congenital defect

✓ Twelve patients are presented with giant arteriovenous malformations of the brain requiring therapy in the neonatal or infant period. Eight patients were operated on, and six survived with no neurological deficit. Four patients were not operated on and all died. The diagnostic clinical triad of enlarged head, cranial bruit, and cardiac failure or enlargement is described, and angiographic characteristics and surgical therapy discussed.