Peripheral aneurysms of the cerebellar arteries. Review of 16 cases.

True congenital peripheral aneurysms of the cerebral arteries are rare and may constitute a special group. The authors report on 16 cases of peripheral aneurysms of the cerebellar arteries; six of them arising from vessels feeding arteriovenous malformations (AVM's). The possible causative role of increased blood flow versus developmental factors in the frequent occurrence in cases of AVM of this otherwise rare type of aneurysm is discussed. In five of the six cases with AVM's (one dural and five parenchymal), the aneurysm rather than the AVM proved to be the source of the hemorrhage. The occurrence of spasm was in inverse proportion to the distance of the aneurysm from the main arteries. The surgical result was good in 11 cases. One patient with associated AVM died, and four patients had residual symptoms.

Dimensional complexity of the EEG in subcortical stroke--a case study.

The conventional electrophysiological methods used for the analysis of the functional characteristics of the nervous system are not able to grasp its non-linear and random features. Of the methods based on the application of chaos-theory the correlation dimension analysis can be used to quantify the complexity of the analyzed signal, such as the electroencephalogram (EEG). The new version (point-correlation dimension, PD2) was used in this study, which is more accurate than the other, currently used algorithms. The purpose of the present investigation was to compare the sensitivity of the methods based on chaos-theory with the traditional electrophysiological ones in a case when no apparent abnormality was present as judged on the basis of this latter methodology. The PD2 was calculated from the EEG recorded in 13 healthy control subjects and in a patient who suffered a small subcortical stroke 2 years prior to the investigation and who was free of neurological symptoms at the time of recording. Compared to that seen in the control group, in the Z-score maps of the scalp distribution of the PD2, a marked asymmetry was seen and the absolute PD2 values showed a low-dimensional area in the parietal region, ipsilateral to the stroke. A relative decrease of the gamma band was found in the frequency power spectra in the same area. It is suggested that the additional information extracted from the EEG by non-linear analysis may increase the sensitivity of electrophysiological methods for detecting brain pathology.

Fluorescein angiography in the surgical treatment of cerebral ischemic lesions.

The present paper summarizes our experiences with intraoperative fluorescein angiography in 50 external carotid artery-internal carotid artery bypass operations. This technique has provided precise localization of the ischemic lesion and aided in selecting the sites and direction of the anastomoses to be performed, as well as in checking the patency of the anastomoses and the area supplied by them. A comparison of X-ray angiography with fluorescein angiography indicates the reliability of the latter in the estimation of the area supplied by the anastomosis.

Stenoses of the distal segments of the internal carotid artery.

In 31 of 51 patients with stenosis of the distal segments of the internal carotid artery, the first symptom was a transient ischemic attack. In spite of the high incidence of angiographically proved emboli, 46 patients remained in good neurological condition. Aspirin was given to all patients. In 4 patients a total occlusion developed, causing severe neurological deficit. This indicates that the danger of occlusion is significantly higher than that of embolization. External carotid-internal carotid artery bypass was carried out in 23 patients; occlusion developed during the postoperative observation period in 4 patients without any neurological consequences. It can be concluded that an EC/IC bypass operation is the method of choice in treating patients with severe distal stenosis or recent mural thrombi.

[Final body height and puberty in idiopathic hypopituitarism]. / Végsö testmagasság és serdülés idiopathiás hypopituitarismusban.

Twenty four children with hypopituitarism were treated with growth hormone from 6-15 years of age until cessation of growth. The height deficit decreased from -4.2SD to -2.2SD. Final height was above the 3rd percentile in half of the patients. There was no difference in final height between patients with and without additional gonadotropin deficiency. Spontaneous puberty started late but at a normal bone age and its course was normal. In girls with gonadotropin deficiency low dose oestrogen given at unchanged growth hormone doses did not accelerate growth. Final height was closely correlated with the degree of growth retardation at the beginning of treatment (r = 0.73, p less than 0.001). In 17 of the 79 patients treated with growth hormone compliance was bad. The main cause of bad compliance was the low educational level of the parents. It is concluded that final height in growth hormone deficiency can be increased with earlier diagnosis and improved compliance.

[Hyperimmunoglobulinemia E (Job) syndrome]. / Hyperimmunoglobulinaemia E (Jób) szindróma.

A patient with hyperimmunoglobulin E (Job's) syndrome is presented. The authors review the clinical and immunological characteristics of the disease and sum up the different explanations for the pathogenesis of the syndrome.