A Case of Pyogenic Ventriculitis Complicating Obstruction of Aqueduct of Sylvius

A rare case of ventriculitis associated with the obstruction of aqueduct of Sylvius is reported and the pertinent literature reviewed. A 24 years old male, who had been suffering from a longstanding chronic pyogenic ear disease since childhood, was admitted to our clinic in Dec. 1973 with a comatose state. Contrast radiology showed the obstructive hydrocephalus with the occluded aqueduct of Sylvius, but neither intracerebral or intracerebellar space consuming mass presented. Cerebrospinal and ventricular fluid revealed a marked growth of Escherichia Coli. So ventriculitis complicating obstruction of the aqueduct of Sylvius due to chronic suppurative otitis media and mastoiditis was diagnosed in this patient, and treated by Torkildsen's operation with proper chemotherapy and resulted in good recovery. We experienced that ventriculitis initiated from meningitis might give rise to obstruction of the aqueduct of Sylvius and it could be considered as a brain abscess superimposed raised intracranial pressure from obstructive hydrocephalus.

A Case of Pyogenic Ventriculitis Complicating Obstruction of Aqueduct of Sylvius

A rare case of ventriculitis associated with the obstruction of aqueduct of Sylvius is reported and the pertinent literature reviewed. A 24 years old male, who had been suffering from a longstanding chronic pyogenic ear disease since childhood, was admitted to our clinic in Dec. 1973 with a comatose state. Contrast radiology showed the obstructive hydrocephalus with the occluded aqueduct of Sylvius, but neither intracerebral or intracerebellar space consuming mass presented. Cerebrospinal and ventricular fluid revealed a marked growth of Escherichia Coli. So ventriculitis complicating obstruction of the aqueduct of Sylvius due to chronic suppurative otitis media and mastoiditis was diagnosed in this patient, and treated by Torkildsen's operation with proper chemotherapy and resulted in good recovery. We experienced that ventriculitis initiated from meningitis might give rise to obstruction of the aqueduct of Sylvius and it could be considered as a brain abscess superimposed raised intracranial pressure from obstructive hydrocephalus.

A Clinical Observation on Posterior Fossa Injury

Posterior fossa injury is a relatively infrequent in all craniocerebral injuries, which may be a rapidly fatal disease unless the diagnosis and prompt treatment are made. Delay in operation or failure to make the diagnosis early may result in death from medullary decompensation. An injury to the occipital region, followed by signs and symptoms of cerebellar or medullary nerve dysfunction, should cause one to suspect the existence of this lesion. It is well to remember that neither the surgically demonstrated presence of a supratentorial clot nor the roentgenological failure to demonstrate an occipital fracure excludes the presence of a mass lesion in the posterior fossa. Authors studied 104 cases of posterior fossa injury admitted at Department of Neurosurgery, Kyung Hee Medical Center from October 5 th, 1971 to August 30 th, 1974. The results were as follows: 1) The incidence of posterior fossa injury was 5.7% of all craniocerebral injuries. 2) The age incidence was greatest in the age group between 10 and 20. 27.9% of all cases were belonged in this group. 3) Common causes were traffic accident(82 cases:78.8%), falls from(14 cases:13.5%) and direct blow(6 cases:5.8%). 4) Male outnumbered female by almost 2 to 1. 5) Common symptoms were disturbance of consciousness(67 cases:64.4%), headache(43 cases:41.3%) and vomiting(24 cases:21.3%). 6) Scalp injuries were demonstrated in 95 cases and occipital, bone fracture in 58 cases under gross and radiological examination of posterior fossa. 7) Time interval between injury and operation was greatest at 3 to 6 hours. 8) In 30 cases of operation, massive cerebellar contusion was 13 cases, extradural hematoma was 7 cases and subdural hematoma was 2 cases and negative exploration was 6 cases. 9) The overall mortality rate was 25%.

A Case of Oligodendroglioma

We have seen a case of oligodendroglioma arising in the left frontal lobe of 64-year-old woman. She had complained of longstanding headache with occasional seizures and episodic dysarthrias for six years before admission. On admission there were drowsy mentality and bilateral papilledema of 3 diopters without other neurological abnormality. The tumor was showed as a calcified mass of an egg size in the left frontal lobe even on the plain skull X-ray films. The tumor was totally removed by surgery and measured 4(5(4cm. On microscopic examination it was a typical oligodendroglioma. The patient was discharged in good condition on the twelfth postoperative day. Many authors reported that the incidence of oligodendrogliomas in all glioma group was relatively rare. In Korea there was no clinical report of oligodendroglioma except only two cases reported by Dr. Lee et al. in 1966. So we present this case, though it was typical and classical in pathological nature and clinical process.