[Jugular chemodectoma with Garcin syndrome]. / Quemodectoma yugular con sindrome de Garcin.

The authors present an exceptional case of chemodectoma jugulare with important invasion of the skull base involving all the cranial nerves on one side and conforming Garcin's syndrome. Practically all the possible ways of spreading were followed by the tumor, with involvement of the posterior, middle and anterior fossas of the skull base and also orbit, middle ear and neck. The clinical and histopathological difficulties in the diagnosis, especially when the chemodectoma has only neurological signs, are stressed. The association of otologic symptoms makes the diagnosis easier. The patient had an early onset of the symptoms and a rapid evolution considering this type of tumors. The appearance of goitre in this patient is a sign of endocrine disturbance, which is occasionally associated with these tumors. Apparently this chemodectoma was not a secreting tumor, since the blood pressure values were normal. No signs of multicentricity or metastatic growths were detected. The radiological studies, and especially computerized tomography scanning, gave precise information about the spreading of the tumor. The authors consider that the knowledge of this entity is important in order to arrive at a correct diagnosis.

[Report of a new case of Cobb syndrome. Meningo-spinal cutaneous angiomatosis]. / Aporte de un nuevo caso de síndrome de Cobb. Angiomatosis cutáneo meningoespinal.

The authors present a 47 years old female patient with cutaneomeningospinal angiomatosis or Cobb's syndrome of thoracic location. This entity, included in the primarily mesodermic phacomatose, is extremely rare, and only 17 cases have been sufficiently documented in the literature on the subject. The rare association with vertebral haemangioma of the same metameric level was present in this patient. The diagnostic criteria, possible associations, pathophysiology and nosological situation are discussed. The telangiectasic type of angioma and the principally extradural location are stressed. The authors concluded on the importance of clinical suspicion of this diagnosis based on a spinal cord syndrome in the presence of a cutaneous angioma of the same metameric level. The necessity of a complete paraclinical studies which includes selective spinal angiography and linear tomography of the spine are also stressed. With this methodology the real incidence of this syndrome will be revealed, permitting a planned surgical treatment which will diminish the high mortality and morbidity of the cases published up to the present.

[Termino-lateral anastomosis of the carotid of the rat. Histological evaluation of permeability in relation to the number of suture stitches and the thread used]. / Microanastomasis término-lateraen la carótida de la rata. Valoración histológica de la permeabilidad en relación al número de puntos de la sutura y al hilo utilizado.

A histological study of end-to-side anastomosis on the carotid arteries of the rat, is presented comparing the results according to the type of suture material and the number of stitches. Two groups of 5 animals were studied. Group "A" in which the 11-0 monofilament nylon (18 microns; needle of 70 microns) was utilized with an average of 11 stitches; and group "B" corresponding to the 10-0 nylon (25 microns; needle of 100 microns) with an average of 8 stitches. The patency of the anastomosis was ascertain in all cases except one where a complete thrombosis of the donor artery was discovered. The fact that there were no difference between both groups is stressed. Other findings were: dehiscence, 3; invagination, 3; partial thrombosis, 4 in spite of actual patency. It was concluded that the 10-0 nylon is easier to handle, and 8 stitches are enough to perform and end-to-side anastomosis in 1mm diameter arteries. A regular distance among the stitches and a balanced tension of knotting are important to prevent or to diminish the risk of dehiscence, first range factor of occlusive thrombosis.

[Tumors of the sellar region and the cavernous sinus. Evaluation of diagnostic procedures and therapeutic orientation]. / Tumores de la región selar y del seno cavernoso. Valoración de la conducta diagnóstica y orientación terapéutica.

Two cases of infrequently seen tumors of the cavernous sinus and the clivus regions are presented. One of them was a chordoma and the other, a myeloma, and both were approached by the transphenoidal route. The clinical picture and the diagnostic procedures are reviewed, and the several surgical approaches to these regions are discussed. These regional processes should be submitted to a precise radiological evaluation: plain skull films, conventional tomography, arteriography, and computerized tomography scan, in order to establish their origin and their extension, and also to determine the proper approach. The authors conclude that all these regional tumors must be operated on, and that the transphenoidal approach is the most effective. This approach is extradural, well known through the experience brought about by the pituitary surgery, and with a low morbi-mortality rate.

[Actinomycotic cerebral abscess. Apropos of a case]. / Absceso actinomicótico cerebral. A propósito de un caso.

A case of an actinomycotic brain abscess in an adult patient apparently free of systemic infection is presented. The rarity of this etiology of brain abscess is underlined. The patient was treated by complete surgical excision and prolonged antibiotic therapy with penicillin. The authors stress the importance of taking into account this infrequent cause of brain abscess, the necessity of radical surgical treatment followed by intensive, prolonged and adequate antibiotic therapy, as the only means of reducing the high mortality rate.

[Dysplastic gangliocytoma of the cerebellum or Lhermittee-Duclos disease]. / Gangliocitoma displásico de cerebelo o enfermedad de Lhermittee-Duclos.

Lhermitte-Duclós disease is an infrequent condition of which there are only 37 cases described in the literature. Although presently considered as a displasic process, its clinical presentation is of a typical posterior fossa tumour and should be treated as such. Even though it is a benign growth there are only 7 cases described with postoperative survival. The uniform pathological anatomy in all the cases presented makes the definitive diagnosis. The authors present a new case with postoperative survival and discuss its clinical presentation, treatment and origin of the disease.

[Brain aging. Ultrastructural study of changes in man and laboratory animals]. / Envejecimiento cerebral. Estudio ultraestructural de algunas alteraciones en el hombre y en el animal de laboratorio.

The authors present a study on ultrastructural changes observed in aged human and animal brain. These changes are analyzed and compared with those described in classic optic microscopy and with those observed in experimental models of the same lesions.

[Clinicopathological analysis of fatal cerebellar hematomas]. / Análisis clinicopatológico de hematomas cerebelosos fatales.

An analysis is made of the clinical observations and pathological findings in 16 fatal cerebellar hematomas admitted at the Instituto de Neurología in Montevideo, over a period of 23 years. The absence of definitive lesions of the brainstem in the majority of cases, in spite of the rich symptomatology of brainstem disfunction (horizontal gaze palsies, vegetative syndrome decerebrate movements) is stressed, as well as the rapid evolution of those cases with intraventricular haemorrhage. Missed clinical diagnosis was also frequent in severely ill patients. Discussion is carried out around the importance of early diagnosis in the correct surgical management. Ventriculostomy alone, not followed by immediate craniectomy, may be highly dangerous. Mere evacuation of the cerebellar, and even of the ventricular clots can result insufficient if not followed by ventricular shunting in cases with ventricular inundation.

[A case of cerebral microglioma]. / A propósito de una observación de microglioma cerebral.

The authors present the first national observation of a microgliosarcoma. The patient, a woman of 57 years old, was admitted with the clinical and paraclinical diagnosis of an intracranial mass occupying lesion. Surgical excision was incomplete, and postoperative radiotherapy was undertaken. Posteriorly, lymphoma classification criteria was used to determine the extension of the process. Due to an abnormal retroperitoneal finding in the lymphangiogram the patient was submitted to a laparotomy following staging procedures and diagnosing tuberculous ganglia without lymphomatous lesions. Considerations are made on the identity of the origin of microglia and the reticuloendothelial system and the different nomenclature used to name this tumor. The necessity of a classification of the extension of lesion according to established norms for lymphomas is stressed and therapeutic procedures are proposed.