Cerebellar abscesses: a review of seventeen cases

Seventeen cases of cerebellar abscesses are reviewed. The incidence was 18% of all brain abscesses. Thirteen were males, and four were females. Headache was the most common presenting symptom. These abscesses have a better prognosis for survival and neurological function than supratentorial abscesses. They are less likely to be encapsulated. Continued neurological decline in the face of adequate surgical treatment of a single abscess should alert the physcian to the possibility of a second abscess.

Experimental study on the genesis of cerebral vasospasm

The cerebral vasospasm produced by blood, fractions of blood, and blood-borne agents administered intracisternally was studied arteriographically to attain a better understanding of the genesis of vasospasm. The results indicate this phenomenon is multifarious in origin, involving a number of spasmogens. Whole blood, platelets, platelet extracts, some isolated components of platelets, plasma, thrombin, histamine, serotonin and prostaglandins F 1α , E 2 and F 2α produced a significant incidence and duration of spasm. Norepinephrine and prostaglandin E 1 were inactive. Spasm produced by arachidonic acid and red blood cells was of questionable significance.

Compared to whole blood, thrombin usually produced spasm which was more delayed in onset while most other active substances produced a shorter-lived spasm. However, among the pure substances tested, serotonin, prostaglandin E 2 and prostaglandin F 2α induced spasm in small doses which most nearly resembled that observed with whole blood.

The hypothesis that the course of spasm depends upon synthesis of spasmogens by brain and blood is advanced. Prostaglandin synthesis plays a major role in this concept.

Experience with 88 consecutive cases of brain abscess

✓ The records of 88 patients with intraparenchymal brain abscess treated during 1946–1971 were reviewed. The incidence of brain abscess did not decline significantly during this period. The overall mortality rate was 36.4%, and the operative mortality rate 29.1%. The most frequent findings were alteration of consciousness, headache, and elevated peripheral white blood cell count; fever, hemiparesis, seizures, neck stiffness, nausea and vomiting, and papilledema were less common. Lumbar puncture was a definite threat to the patient with a brain abscess. Ventriculography appeared slightly superior to angiography in accurately localizing the site of the abscess. There was a close correlation between the preoperative level of consciousness and the operative mortality rate. With the aid of Thorotrast, simple aspiration or drainage was superior to excision; when Thorotrast was not used, excision produced better results. The rate of postoperative seizure disorder was similar regardless of the type of treatment. The operative mortality rate and the postoperative neurological sequelae were less for intracerebellar abscesses than for intracerebral abscesses.

The measurement of cerebral infarction edema with sodium 22

Sodium 22 was used to determine quantitatively cerebral infarction edema in cats after occlusion of the middle cerebral artery. A comparison was made of the sodium 22 edema determination with the wet weight-dry weight method of edema determination. There was a high degree of correlation between the two methods. The sodium 22 method of measuring cerebral infarction edema was less time consuming and easier than the wet weight-dry weight method, and served as a reliable means of quantitatively comparing the edema content in the hemispheres of animals with stroke.

The effects of four hypnotic drugs and placebo on normal subjects' sleeping and dreaming at home

Hypnotic drugs are most commonly used with patients at home, yet with few exceptions (Ghernish, Gruber and Kohlstaedt, 1956) most trials of hypnotic drugs are carried out in hospitals. Studies on such patients by general practitioners are valuable, but they often rely on retrospective or other forms of delayed reporting and their validity is thereby somewhat limited. This preliminary study therefore compared four widely used hypnotics with a placebo when normal subjects were sleeping at home. Their impressions of the quality of their sleep and other information, including their dreams, were collected by telephone the morning after the drug had been administered. All subjects were healthy and did not complain of sleep disorders; neither before nor at the time of the trial were they taking either hypnotics or other medication.

Muscular Atrophy and Weakness in Thyrotoxicosis (Thyrotoxic Myopathy; Exophthalmic Ophthalmoplegia)

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