A rare case of basilar-middle meningeal arterial anastomosis is reported. Pertinent literature is reviewed and an embryological explanation of this anastomosis is discussed.
SUMMARY Seventy-four patients with hypertensive putaminal hemorrhage (HPH) were followed at least 6 months after treatment and estimated by ADL. They were graded according to the state of consciousness on admission. The grading consists of 6 grades: Grade 1, fully conscious; Grade 2, somnolent; Grade 3, stuporous; Grade 4, semi-comatose; and Grade 5, deeply comatose. Removal of HPH was performed in 18 patients and conservative treatment was done in 56 patients. The mortality in surgically treated group was 28% while that in conservatively treated group was 14%. The patients who returned to full work or independent life without disability and with minimal disability after surgical treatment were, 50% in Grade 1, 33% in Grade 2, and 50% in Grade 3. The patients without disability and with minimal disability after conservative treatment were; 87% in Grade 1,80% in Grade 2, and 22% in Grade 3. None below Grade 4 returned to full work or independent life in both groups. There was good correlation between the state of consciousness and CT findings on admission. There was no correlation between good recovery and the side of HPH. Our results do not support the view that the surgical treatment is superior to the conservative one in the management of HPH.
Malfunction of a ventriculoperitoneal shunt is reported in a 25-year-old woman at 32 weeks of gestation. Pregnancies and delivery in women with cerebrospinal fluid shunts are rarely reported, and malfunction of a shunt system during pregnancy is extremely unusual.
Parinaud syndrome, associated with a left thalamic hemorrhage, disappeared completely in a 57-year-old woman after ventriculoperitoneal shunt. The syndrome may be attributed to increased intracranial pressure owing to mass effect on the pretectal region and tectum, or to tightness in the incisura causing hydrocephalus secondary to aqueduct compression. The lesions responsible for the syndrome may not be irreversible.
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