[Treatment by a direct surgical approach of a false arterio-venous traumatic aneurysm between the vertebral artery and the internal jugular vein at the level of the atlas (author's transl)]

The authors report a case of traumatic arteriovenous fistula between the vertebral artery and the internal jugular vein at the level of the atlas, treated successfully by a direct surgical approach which permitted exclusion after simple dissection. The relative ease of the surgical approach of the suboccipital segment of the vertebral artery may permit one to extend this technique to other more common indications, in particular due to atheroma.

Relevance of antibiotics in the treatment of brain abscesses. Report of a case with eight simultaneous brain abscesses treated and cured medically

A case of eight simultaneous brain abscesses in the right cerebral hemisphere, treated medically after puncture of two of them, is reported. Antibiotics and hypertonic mannitol and, after seven days, dexamethasone were sufficient to cure these lesions. CT scan was of primary importance to follow the evolution under treatment. To get the best efficiency from antibiotics, identification of the microorganism and assessment of its resistance to antibiotics are necessary. It is suggested that in certain conditions medical therapy might be sufficient to treat cerebral abscess, after simple puncture to isolate the infecting agent. Corticosteroids should be avoided in the acute phase because they prevent antibiotics from penetrating the abscesses.

[Exposure of the extracranial portion of the vertebral artery. Anatomical study--Surgical value (author's transl)]

Exposure of the vertebral artery, in particular in its extracranial course, may be of surgical value. The treatment of lesions affecting this entire artery must be discussed in the context of the revascularisation of the vessels supplying the brain. The anatomical study forms defines the features of this surgical approach. Selective vertebral arteriography and the assessment of tolerance of vertebral clamping are the main features of pre-operative evaluation.

Surgical treatment of chronic subdural hematomas in infants

Subdural hematomas in infants are associated with a high risk of recurrence. In an effort to combat this risk, a surgical procedure consisting of excision of the subdural membranes, a reduction of the craniocerebral disproportion and a restoration of the normal angle of junction of the cerebral bridging veins and the superior sagittal sinus is proposed.

[Reticular activity and intracranial pressure. Acute and chronic intracranial hypertension (author's transl)]

Modifications of mesencephalic and bulbar reticular formation activity were studied with microelectrodes during acute and chronic intracranial hypertension. In both cases, the mesencephalic reticular activity increased progressively until a pressure level of 70 to 90 cm of CSF was reached and then fell irreversibly to less than the base value. The bulbar reticular activity followed the same pattern but more slowly. Different hypotheses are advanced to explain these modifications and their meanings.

[Attempt at explaining decompensation of hydrocephalus by modifications of reticular activity]

A correlative study is done between observation of cases of shunted hydrocephalus with mesencephalic signs such as Parinaud's syndrome and a multiunitary recording of mesencephalic and bulbar reticular formation activities during acute and chronic intracranial hypertension in cats. Clinical and experimental data are first separately analysed and then superimposed. This results in analysing the evolution of such intracranial hypertension in three stages: first stage of "tolerance" with minimal clinical signs and no change of reticular activity; second stage of "uncompensation" when mesencephalic signs appear and with increased mesencephalic activity and unchanged bulbar activity; third stage of "exhaustion" where can be noted disorders of consciousness, decerebration fits, and cardiorespiratory disorders; mesencephalic activity falls down to lower levels than basal ones, bulbar activity increases first and then also decreases rapidly. This suggests a mechanism of exhausting stocks of monoamines but also of change of the local cerebral blood flow. Increase and then fall of the reticular activity may be the general way, even without any herniation, of evolution of any intracranial hypertension of traumatic or tumoral origin.

An evaluation of the self administration of DDS in Gudiyatham Taluk

This study using the dapsone/creatinine (D/C) ratio was undertaken to find out how many of the patients attending the Village Clinics were actually taking the DDS tablets. The Urine D/C ratio was estimated in 35 patients who were receiving a supervised daily dosage of either 50 or 100 mgs of DDS. The D/C ratio was also estimated in 100 out patients who were on either 50 or 100 mgs of dapsone. It was determined that 72% of this group had taken DDS in the previous 24 hours. It was also seen that the 55 patients who were receiving 100 mgs of DDS had taken 79.3% of their dapsone dosage, and the 45 patients receiving 50 mgs of DDS had taken 96% of their dosage.

[Von Eulenburg's congenital paramyotonia and aptitude for military service. Cases taken from a family with 25 cases since 1789]

The authors present four cases of von Eulenberg's paramyotonia. From the family history it was possible to follow the condition through seven generations since 1780; it confirms the autosomal dominant nature of genetic transmission, with almost complete penetrance. From the clinical standpoint, the condition observed is particularly pure, occurring exclusively in the cold. At no time were paralyses or adynamia independent of the myotonic phenomena and of temperature variations observed. The laboratory investigations carried out, ionic and enzyme, showed no abnormalities. Electromyographic study showed the presence of numerous true myotonic out-bursts, variable in shape and in amplitude, independant of the myotonic phenomenon, and present in the absence of exposure to cold. The effects of the condition on aptitude for military service are examined and in this respects the author recalls that the history of myotonia is intimately bound up with medico-military problems.

The presence of Hb J alpha15 Gly leads to Asp in an Italian family in the United States

A fast-moving hemoglobin variant was detected by electrophoresis. Sequence analysis revealed a substitution of glycine by aspartic acid at position 15 in the alpha chain.

Hemoglobin hope: beta136 (H13) Gly leads to Asp in Georgia

A fast-moving hemoglobin variant was detected in a screen for abnormal hemoglobins. Structural analysis shows that there is a substitution of glycine by aspartic acid at position in 136 in the beta chain.

Variations of intraventricular pressure during pneumoencephalography

✓ Intraventricular pressure was studied in eight patients during and after diagnostic pneumoencephalography. In cases with normal initial pressure and normal cerebrospinal fluid (CSF) dynamics, variations in pressure were moderate, immediate, and disappeared at the end of the examination. In cases of normal-pressure hydrocephalus, there was a slow but relatively important elevation that continued for at least 24 hours. In cases with intracranial hypertension, there was a rapid significant increase; return to normal depended principally upon the flow from a large CSF compartment.

The hypocalcaemic activity of glucagon: demonstration of independence from endogenous calcitonin secretion in the rat

In the past glucagon (GN) has been shown to be a hypocalcaemic and hypophosphataemic agent in pharmacologic doses in rats, rabbits, dogs, and humans. These activities have been suggested to be due to GN causing an increase in the secretion, or release, of calcitonin (CT) from the C cells. A series of experiments in rats is reported which demonstrate: 1) GN does not produce hypocalcaemia in chronically parathyroidectomized rats; 2) GN produces hypocalcaemia in acutely thyroparathyroidectomized rats; and 3) GN produces hypocalcaemia in thyroparathyroidectomized rats with autologous parathyroid transplants. It is concluded that endogenous CT is unnecessary for the hypocalcaemic activity of GN. Other evidence suggesting an unconcerted hypocalcaemic effect of GN is discussed.