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Es werden zwei Formen von Hypertrophie des Dens Epistrophei beschrieben, die beide als Manifestation des Okzipitalwirbels angesehen werden konnen.

Five patients with gross obesity were subjected to an electrostimulatory exploration of the lateral hypothalamic area. In three cases a convincing hunger response was elicited. Two of these patients received unilateral electrocoagulatory lesions, and in the third a contralateral (left sided) coagulation was performed three months later. In contrast to the two patients who had only been explored, the patients with lesions showed a statistically significant, but transient decrease from preoperative to postoperative spontaneous calorie intake. Body weight decreased slightly and temporarily, but was not significantly affected. It is concluded that in humans, as well as in experimental animals, the lateral hypothalamus is the site of nuclei or tracts that are related to hunger.

The clinical aspect and mechansims of production of ocular motor disturbances appearing as false localizing signs are discussed in four patients who were observed in a series of 102 consecutive admissions of patients with ruptured intracranial aneurysms. The aneurysms were located on the anterior communicating artery and the precommunicating segment of the right anterior cerebral artery.

Under controlled conditions, the possibility of recording from the epidural space a pressure higher than the pressure existing in the subdural space was reproduced. The phenomenon occurs when the epidural device records pressures deriving from a dural area larger than the area directly contacting the device. These results are obtained only when the epidural devices are shaped or placed in such a way to displace the surrounding dura from the bony face.

L’attitude vis-a-vis d’une ulceration gastrique est dominee par sanature cancereuse possible.

Les cancers bronchiques distaux representent 10% de l'ensemble des cancers broncho-pulmonaires.

The rupture of a saccular aneurysm during a direct attack can led to a disastrous result unless deep hypotension has been induced before the dissection. If the mean pressure recorded through a microcatheter introduced into the radial artery is at 30 mm Hg level or below the rupture remains circumscribed and the operative field can be dried easily with adjustable suction wherever the situation of the rupture may be. This technique was used in 52 cases with the operative microscope which enables, a clear vision of the lesion and of its vicinity. The mortality was 2, or 3.8%, in spite of 34 operative ruptures.

Es werden die klinischen Charakteristika der haufigsten Bruckenwinkeltumoren in Form der Geschlechtsdisposition, des typischen Erstsymptoms, des Liquorbefundes, des Verteilungsmusters der Hirnnervenausfalle, der rontgenologischen und szintigraphischen Befunde dargestellt. Es ergeben sich dabei aus der Kombination der haufigsten Symptome Signifikanzen, die eine artdiagnostische Voraussage ermoglichen.

An attempt has been made to evaluate the prognostic value for surgery of some diagnostic findings in 15 patients with normotensive hydrocephalus. The results of CSF surgical shunting were considered in relation to the results of pneumoencephalography and isotope cisternography with I131 HSA. In addition, the data obtained by the estimation of the transfer of isotope labelled serum albumin from CSF to blood have been considered. Ten patients showed remarkable improvement following surgery, five did not. From the results of the present study it appears that no one of these diagnostic investigations gives a reliable surgical prognosis which may, however, be obtainable by integrating the results of the different examinations. The following combination of findings appears highly suggestive of good surgical prognosis: ventricular enlargement and everted anterior medullary velum with no signs of cerebral atrophy in the pneumoencephalogram, plus ventricular filling in the isotope cisternographic scans. The additional finding of retention of the isotope labelled serum albumin may further strenghthen the prognostic information.

A case of “spontaneous cure” of an intracranial aneurysm is reported and 7 cases verified by follow-up angiography are reviewed. The autopsy finding of spontaneously thrombosed aneurysm is discussed.

Six observations particulieres illustrent l’interet de l’oesophagoscopie precoce dans les ingestions de corps etrangers. L’extraction par l’endoscope evite bien souvent la thoracotomie.

Le transit baryte en double contraste permet de deceler des lesions meme minimes des faces et de la grande courbure, en plus des lesions de la petite courbure.

Familial occurrence of intracranial aneurysms, though rare, is a recognized phenomenon. The author has added 6 cases in 3 families and reviewed the world literature on this subject. There are a total of 88 cases verified by angiography, surgery or autopsy occurring in 41 families. Various associated diseases and anomalies are mentioned. A familial occurrence lends support to the theory of congenital origin of intracranial aneurysms.

Attendu qu’il y a un considerable nombre de patients operes de l’estomac chez lesquels la symptomalologie, meme grave, peut etre directement dependante de la presence de materiel de suture qui fait saillie dans l’estomac, les auteurs decrivent une technique pour l’extirpation per-endoscopique de la suture entiere.

The authors report on their experience and their results in the diagnosis of bronchial cancers.

In the course of hydrocephalus treated by ventriculoatrial shunt revision operations are often necessary mostly for elongation of the catheter. After several revisions it may became difficult or even impossible to introduce the catheter into the auricle through the jugular vein. The authors report on 19 direct cardiac implantations using a medial sternotomy. Operative technique, complications and results are described. This approach proved to be very safe and useful and seems to be superior to the thoracotomy already recommended by other neurosurgical teams. But it is not recommended for children under the age of 3 years.

We have presented a case of a myoctic aneurysm occurring after purulent meningitis, in which the aneurysm was successfully excised. Current theories of etiology and treatment are reviewed and discussed.

Bericht uber eine 23jahrige Patientin, die wegen eines Hypophysentumors operiert wurde. Schon 3 Wochen nach dem ersten Eingriff war eine Recidiv operation erforderlich; 6 Monate spater verstarb die Patientin trotz intensiver strahlentherapeutischer Behandlung. Die Geschwulst erwies sich als Hypophysencarcinom mit intracerebralen Metastasen. Eine erhebliche Zunahme der Malignisierung war im Vergleich der beiden Operationspraparate erkennbar.

Es wird ein kurzer Uberblick uber die bei achondrodysplastischen Zwergen vorkommenden Wirbelsaulenveranderungen gegeben. Die haufig neurologischen Ausfalle beruhen in der Regel auf einer Kompression des Ruckenmarkes und/oder der Cauda equina in dem verengten Wirbelkanal.

Nach einem klinischen Uberblick uber die Haufigkeit der sogenannten „zentralen“ akuten Magen-Darmblutungen und uber die Vielgestaltigkeit ihrer auslosenden Faktoren wird darauf hingewiesen, das die akuten Blutungen aus dem Magen-Darmtrakt oft mit Erkrankungen der Lunge vergesellschaftet sind.

Mitteilung eines hochst seltenen Falles, bei dem ein solitares Clivus-Meningeom mit einem solitaren Acusticusneurinom kombiniert vorkam.

The regular use of phlebography makes an improvement in the diagnosis of cerebral tumors possible. The following angles are of special clinical interest: 1. It is possible to measure the rate of streaming blood in the cerebral circulation, thereby gaining knowledge of disturbances in the blood circulation which might bring about a diminution of cerebral efficiency. 2. In case of pathological variations of site the constantly equal course of vena magna Galeni and vena basilaris accord important hints in regard to tumors in the depth of the brain, which it is impossible to diagnose during the arterial phase through photographing. 3. Direct representation of tumors by angiography permits a diagnosis of species. A particularly good differentiation of glioblastoma, meningioma and metastasis may be obtained by phlebograms. 4. Description is made of medical cases where the diagnosis in regard to the site of the tumor was only made possible by a phlebogram.

Se presentan dos casos de meningiomas intraventriculares del cuarto ventriculo, senalando la rara ocurrencia de los mismos. En la literatura revisada solo fue posible encontrar cuatro.

Le bilan des 100 premieres broncho-fibroscopies permet aux auteurs de preciser les indications de cette technique originale d'endoscopie bronchique. Les images radiologiques para-hilaires non explorables par la bronchoscopie rigide paraissant etre les indications ideales.

The results of combined irradiation and intravenous Vincristine therapy applied to 18 malignant glioma patients after operation and reoperation are reported. Histological examination of the first 15 tumours showed that 12 were glioblastomas and 3 malignant astrocytomas. Tumours removed by reoperation were glioblastomas.

A critical analysis of 23 cases of thoracal disc prolapse observed by the authors as well as of 168 cases gathered from the literature is made. The different etiological factors are considered and the signification of the different kind of traumas is stressed. It is shown that in cases with a long clinical evolution local pain may be absent and the absence of radicular pain in some cases may be due to the relative great distance between a median disc prolapse and the posterior root. In search for a more adequate technique for the removal of the prolapsed disc an analysis of the different surgical approaches is made. The results obtained in 19 cases aut of the total number of cases are presented because in 2 cases a coexistent vertebral tumour has been found and in 2 cases the time follow-up was too short. There was one post-operative death, 1 late death, 3 patients were not benefited by the operation, in 6 the result was fair, good in 4 cases and excellent in 4 cases.

Three cases of cerebral fat embolism have been reported: 2 cases were verified at the autopsy, while the third one survived, with no sequelae, 2 showers of fat embolism. The exact diagnosis in the last case was made clinically and proved by the presence of fat globules in the urine.

The authors analyze 81 cases of cerebral abscess in children admitted to the Clinic of Neurosurgery Bucharest, from 1936 to 1964; these cases represent 15 per cent of the total number of 542 cerebral abscesses treated in the clinic.

The results of the combined electro- and echo-encephalographic examinations in 321 patients with a cerebral tumour are given. In 15 of 62 tumours in the posterior fossa and in 8 of 26 cases with tumour in the hypophysial region both examinations gave negative results. Of 233 supratentorial tumours (not in the hypophysial region) all but 2 E.E.G.'s were abnormal and 82% of these tumours caused a shift of the midline-echo. As a reliability test a group of 500 out-patients was screened. Of this group 216 patients had a normal E.E.G. and echo-encephalogram. Although a parietal meningioma was found to be present in one of them.

Les AA. presentent 2 cas de neurilemome (neurinome) malin et discutent le probleme de la malignite clinique et histologique de ces tumeurs.

Coma and decerebrate rigidity in the absence of any demonstrable expanding intracranial lesion were noted in six young patients following head injury. It is assumed that in most of the cases coma and decerebrate rigidity were not secondary to tentorial herniation but were more than likely the result of direct involvement of the brain stem. However, such a mechanism cannot necessarily be implicated in those cases in which the decerebrate state appears late in the course of the illness. Nearly complete recovery occurred in all cases. This was spontaneous and not the result of emergency surgical procedures, although exploratory trephinations were performed in several instances. The state of consciousness returned to normal before spasticity regressed and none of the patients showed signs of impairment of intellectual function.

L'etude radiologique des lesions vasculaires cerebrales, anevrismes sacculaires et angiomes arterio-veineux, presente aujourd'hui encore des difficultes aussi bien techniques que diagnostiques.

Technische Beschreibung der Leukotomie beim Hunde. Es ist eine leicht ausfuhrbare Methode zu physiologischen und morphologischen Studien.

Nach einer schweren halbkreisformigen, prazentralen Impressionsfraktur wird an gleicher Stelle ein Aneurysma der A. pericallosa angiographisch festgestellt. Nach 5 Monaten tritt im Befinden des aphasischen und antriebslosen Verletzten plotzlich eine entscheidende Verbesserung ein, worauf der Kranke sprach- und gellfahig wird und 4 Wochen spater beschwerdefrei entlassen werden kann. Bei der Kontrollarteriographie vor der Entlassung kommt das traumatische Aneurysma nicht mehr zur Darstellung, so das eine spontane Thrombosierung angenommen wird. Durch die Thrombose des Aneurysmas durften sich die Zirkulationsverhaltnisse im Gebiet der A. cerebri anteriores praktisch normalisiert haben und die klinische Heilung ermoglicht haben.

Bericht uber einen Fall, bei dem sich nach Teilexstirpation eines mediaen Keilbeinmeningioms und Verschlus der A. carotis interna eine angiographisch nachweisbare Anastomose zwischen dem Stromgebiet der A. carotis externa und dem der A. carotis interna (wahrscheinlich zwischen der A. meningea media und der A. cerebri media) ausgebildet hat.

L'auteur apporte le resultat de son experience avec 40 tumeurs de la moelle operees chez l'enfant.

1. Report of a clinical case of a patient with a left-sided homonymous lateral hemianopia, suddenly arisen and accompanied with a slight brachial monoparesis. 2. The arteriography of the carotid and the pneumoencephalography give a negative result. Stereoscopic arteriography of the vertebral artery shows a thrombosis of the posterior cerebral artery at about 1 cm distance from the bifurcation of the basilar artery. 3. A month later, the patient developed a thromboangiitis obliterans of the lower limbs.

Fourteen patients suffering from cerebral glioma were treated after craniotomy with an intracarotid infusion with Methotrexate (50 mg daily) for a fortnight.

167 cases of consecutive ruptured intracranial supraclinoid aneurysms verified by lumbar puncture and angiography are presented.

Mitteilung eines operativ verifizierten Falles von Haemangioma arteriovenosum aneurysmaticum der Cauda equina, der bei Myelographie mit wasserloslichem Kontrastmittel ein fur GefA\anomalien typisches Bild geboten hatte. Besprechung der zum Thema vorliegenden Literatur und der chirurgischen Therapie.