In a controlled, prospective, randomized investigation, started in 1974, 118 patients with supratentorial astrocytoma Grade III--IV were divided into three groups. Groups 1 and 2 received 45 Gy postoperatively to the whole supratentorial brain. Bleomycin in 15-mg doses and a total dose of 180 mg or placebo was given intravenously three times a week, one hour prior to radiotherapy, during weeks 1, 2, 4 and 5. Group 3 received conventional care but no radiotherapy or chemotherapy. Median survival rates of patients were 10.8 months in Groups 1 and 2, and 5.2 months in Groups 3, a statistically significant difference. With regard to performance, the patients in Group 3 deteriorated faster than patients in Groups 1 and 2. Bleomycin had no positive or negative influence on survival.

Ninety-one patients operated on for focal epilepsy between 1952 and 1973 have been followed regularly. Nontumoral lesions were found in 68 patients, and tumors in 23. Of the 50 patients without tumor who have been followed for more than 2 years, 30% were seizure-free, 50% improved, while only 20% did not benefit from the operation. There was no operative mortality. Ventricular asymmetry in the pneumoencephalogram was associated with a better prognosis than when there was no or symmetrical enlargement. The time between the onset of seizures and the operation did not affect the prognosis, but early operation is important to achieve better and quicker rehabilitation. There was a positive correlation between the postoperative ECoG and EEG and the clinical results.

Postoperative MR imaging of craniopharyngiomas demonstrated tumour volume reduction and tumour remnants not seen at surgery. Early postoperative MR imaging of craniopharyngiomas may overestimate the size of residual tumour. Improved visualization of peritumoral structures may be achieved.

findings in patients undergoing transsphenoidal surgery of pituitary macroadenomas in order to evaluate the ability of wanted to evaluate the usefulness of i.v. contrast medium in these patients. MR findings before and after transsphenoidal surgery were evalimages with 2 or 4 acquisitions were obtained, using 3-mm slice thickness and 0.3-mm interslice gaps. Of 18 M R examinations, 13 included coronal i.v. contrast medium enhanced images. Image uated in 6 cases. TI-weighted (T R / T E 600/20) sagittal and coronal MR to demonstrate the anatomic results. Furthermore, we quality, sinus cavernosus invasion, identification of normal pituitary tissue and tumor size were examined. All M R studies clearly demonstrated the macroadenomas whether 2 or 4 acquisitions were used, and whether i.v. contrast medium was administered or not. Surgically confirmed sinus cavernosus infiltration was seen in 4 patients. The pituitary stalk was identified separate from the tumor in 2 patients. and the gland in one. There was reduction in tumor size over time, indicating that final radiologic assessment after transsphenoidal surgery is best performed 4 to 6 months postoperatively. It should not be necessary t o routinely include i.v. contrast medium injection in the postoperative evaluation of macroadenomas.

MR findings before and after transsphenoidal surgery were eval uated in 6 cases. Tl-weighted (TR/TE 600/20) sagittal and coronal images with 2 or 4 acquisitions were obtained, using 3-mm slice thickness and 0.3-mm interslice gaps. Of 18 MR examinations, 13 included coronal i.v. contrast medium enhanced images. Image quality, sinus cavernosus invasion, identification of normal pituitary tissue and tumor size were examined. All MR studies clearly demon strated the macroadenomas whether 2 or 4 acquisitions were used, and whether i.v. contrast medium was administered or not. Surgical ly confirmed sinus cavernosus infiltration was seen in 4 patients. The pituitary stalk was identified separate from the tumor in 2 patients, and the gland in one. There was reduction in tumor size over time, indicating that final radiologie assessment after trans sphenoidal surgery is best performed 4 to 6 months postoperatively. It should not be necessary to routinely include i.v. contrast medium injection in the postoperative evaluation of macroadenomas.