[Surgical treatment of intracranial hematoma in an infant with hemophilia B (author's transl)]

Surgical experience of intracerebral hematoma in an 8-month-old boy with severe hemophilia B, which was not diagnosed preoperatively, was presented. Carotid angiography and removal of hematoma by craniotomy were carried out quite safely under fresh-blood-transfusion. After several months ventriculoperitoneal shunt was placed, because of progressing hydrocephalus and multiple porencephaly, this time, under the cover of the factor IX complex. The clinical features of the intracranial hemorrhage in hemophilia were discussed, with analysis of 52 operation cases. Whenever we encounter a patient with intracranial hemorrhage, especially in infancy, hemorrhagic diseases, as hemophilia, must always be borne in mind. Although intracranial hemorrhage is still the most fatal complication of hemophilia, the surgical risk has been greatly diminished by advanced replacement therapy. We stress the need of immediate diagnosis and positive surgical treatment with adequate replacement therapy, if indicated.

Clinical and radioisotopic follow-up study of 'Moyamoya'

24 children with 'moyamoya' had average follow-up periods of 5 years and 9 months. The following factors were noted to influence the prognosis for mental function: early onset, repeated transient ischemic attacks followed by residual neurological deficit, symptoms suggesting bilateral or dominant hemispheric lesions, and angiographically widespread occlusion. Futhermore, radioisotopic procedures could replace angiography for follow-up studies of patients with Moyamoya.

[Three cases of spontaneous bilateral external carotid-cavernous sinus fistula (dural arteriovenous shunts in the region of the cavernous sinus) (author's transl)]

Since Fincher reported a case with arteriovenous fistula between the external carotid artery and dural sinus, many type of cases have been reported. On the other hand, so called the external carotid avernous fistula has been recognized less 20 cases in literature. We have observed three additional cases of dural arteriovenous shunts in the region of the cavernous sinus. Case 1. A 52 year old woman had suffered from left side sever headache. There was weakness of the left extraocular muscles and left ptosis. A bruit was heard over the left orbit. She was treated for hypertension since 38 year old. And she has no history of recent trauma. Selective internal and external carotid angiographies showed the bilateral external carotid cavernous sinus fistula. No operative treatment was performed in this case and the symptomes disappeared with decrease of blood pressure. Case 2. A 50 year old man came to this clinic with chief complaints of right ptosis, diplopia and headache. He was treated for diabetes mellitus and hypertension for six month...