✓ A patient is described who developed an acute, occult, lumbosacral nerve root meningocele following a partial traumatic avulsion of the L-4 and L-5 nerve roots accompanied by fracture of the pelvis and fibula. Almost total functional recovery ensued. The differences between acute and chronic nerve root meningoceles are discussed, as well as the possibility of surgical intervention.
THE VALUE of electroencephalography in clinical work is reflected in the vast literature which has developed on this subject since Berger's original report in 1929. It has become apparent, however, that if the diagnostic value of electroencephalography is to be extended, activation techniques must be developed and assessed. One must alter the resting tracing by physiological or pharmacological means if one is to obtain additional information. Although this was appreciated in part at an early stage in the case of hyperventilation, other methods of activation have been investigated only within the past few years. Such techniques must be studied in a systematic fashion if their indications, potentialities, and limitations are to be fully understood.Among the various methods of activation being tried in our laboratory, cerebral hypoxia as produced by carotid artery compression has shown some promise, and it is the purpose of the present report to record our initial results with this technique. That cerebral function is greatly affected by acute anoxia is not surprising, con¬ sidering that the brain, although only 2% of the body weight, requires 14% of the total cardiac output and uses approximately 22% of the total oxygen consumption of the body.1 Numerous workers * have shown that cerebral hypoxia may be reflected in changes of the electroencephalogram. Engel and Romano 10 observed that the EEG ' improved when 100% oxygen was given to delirious patients with either heart or pulmonary failure, Cheyne-Stokes respiration, or anemia. Similarly, the EEG of patients with severe anemia was found to improve after blood transfusion. Engel, Webb, and Ferris 11 reported the significant changes in frequency distribution which occur at altitudes of 10,000 ft. (3,000 meters) and progressively increase at higher altitudes.There are several reports in the literature concerning EEG changes after carotid artery ligation.f Digital occlusion of the ipsilateral carotid artery in a case of carotidcavernous aneurysm 14 produced loss of consciousness, contralateral Jacksonian seizures, and marked delta activity over the ipsilateral hemisphere 8 to 10 seconds after the occlusion ; incomplete compression and carotid sinus massage produced no changes. Carotid compression repeatedly applied during a six-month period con¬ tinued to give the same results.
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