[Two cases of colloid cysts of the third ventricle with nasal rhinorrhea]. / Dwa przypadki torbieli koloidowej III komory z plynotokiem przez nos.

The authors present 2 cases of tumours of third ventricle with intracranial hypertension and cerebrospinal fluid rhinorrhea. The cause of the CSF rhinorrhea most often was thinning of lamina ethmoidalis and dura mater and rarely intussusception of arachnoidea into the intrasellar space in patients with oval orifice for the stalk of pituitary body due to prolonged intracranial hypertension. Efficacious treatment of CSF rhinorrhea comprises not only removing of the tumor but also introducing the valve and in some cases tightening of the base of the anterior and middle fossa.

[Dissecting aneurysm of the posterior inferior cerebellar artery]. / Tetniak rozwarstwiajacy tetnicy mózdzkowej tylnej dolnej.

A 23 year old woman with dissecting aneurysm of the left posterior inferior cerebellar artery located distal to the branch feeding medulla oblongata is described. Trapping of the aneurysm with the aid of 2 clips was without any influence on neurological state of the patient and prevented recurrent hemorrhage.

Blood pressure and metabolic control as risk factors for nephropathy in type 1 (insulin-dependent) diabetes.

The respective rôles of arterial blood pressure and metabolic control in different stages of diabetic nephropathy were analyzed retrospectively in 52 sequentially-followed Type 1 (insulin-dependent) diabetic patients. A negative correlation was found between median post-prandial blood glucose and median duration of diabetes until onset of persistent proteinuria (p less than 0.01). Systolic blood pressure was higher in patients who subsequently developed persistent proteinuria than those who did not (140 versus 121 mmHg; p less than 0.05), but duration of the interval until onset of persistent proteinuria was not related to blood pressure. After onset of persistent proteinuria, hypertensive diabetic patients developed elevated serum creatinine concentrations more frequently than normotensive diabetic patients (67% versus 14%, p less than 0.05). In these patients, the delay until elevation of serum creatinine concentration was negatively correlated with blood glucose (p less than 0.01). Once serum creatinine was raised, decay of renal function occurred faster in patients with persistent than intermittent hypertension (p less than 0.05). No effect of metabolic control was demonstrable at this stage of nephropathy. It is concluded that metabolic control determines the early course of diabetic nephropathy, whereas blood pressure is more important in advanced stages of nephropathy.