Intercavernous venous communications in the human skull base.

The intercavernous communications of the skull base were studied in 32 sphenoid blocks using electrolytic decalcification techniques, vascular filling, x-rays, and serial anatomical sections. In this study four intercavernous connections were found: anterior intercavernous sinus (AIS), posterior intercavernous sinus (PIS), inferior intercavernous sinus (IIS), and basilar plexus (BP). The AIS was present in 100% of the cases, with diameters ranging from 0.57 mm to 5.43 mm; in 17 cases (53.12%) it took up the whole anterior wall of the hypophyseal fossa. The PIS was also detected in 100% of the cases, and its diameters ranged from 0.71 mm to 4.14 mm. The IIS was identified in 31 cases (96.9%), assuming three different forms: plexuslike, venous lake, and mixed. The BP was found in 100% of the material analyzed; in 23 cases (71.9%) it proved to be the widest intercavernous communication.In 12 cases of this series the hypophysis was completely enveloped by venous structures, except at the level of the sellar diaphragm.

Spontaneous intracerebellar hematoma during childhood.

The case of surgically treated spontaneous intracerebellar hematoma in a 6-year-old girl is reported. Such hemorrhages in this age group are very rare, but must be recognized and promptly treated. Usually associated with the rupture of vascular malformations, they are different from those occurring in adults, and operation is indicated to secure a favorable prognosis.

Persistent primitive trigeminal artery aneurysm.

The trigeminal artery is the most common persistent carotid-basilar anastomotic channel observed in adult life, and its occurrence probably represents a defect in cerebrovascular development. It can be associated with other congenital abnormalities such as cerebral aneurysms, but only rarely do aneurysms of the primitive trigeminal artery itself arise. The authors present a new case of an aneurysm arising directly from the primitive trigeminal artery and discuss its significance and treatment.

[Acute pulmonary edema secondary to a posterior fossa tumor: report of a case]. / Edema agudo de pulmão secundário a tumor de fossa posterior: registro de um caso.

A case of a 44-year-old woman presenting pulmonary edema secondary to posterior fossa meningioma is reported. The authors have tried to demonstrate the relationship between a lesion occupying space in the posterior fossa and important pulmonary abnormality such as interstitial edema based on increasing A-aDO2 (oxygen alveolar arterial gradient) in this peculiar case. A-aDO2 is easily measured and represents a good guide for evaluating the efficiency of medical and neurosurgical management when it is done in the serial way, particularly in those cases of non cardiogenic pulmonary edema.

Edema agudo de pulmao secundario a tumor de fossa posterior: registro de um caso. / Acute pulmonary edema secondary to posterior fossa tumor: report of a case

E relatada a observacao de uma paciente de 44 anos de idade com quadro clinico de edema de pulmao secundario a meningioma situado na fossa posterior. Sao feitos comentarios sobre a importancia da gasometria arterial realizada no periodo pre e pos-operatorio e especialmente sobre o gradiente alveolo-arterial de oxigenio que serve de guia na avaliacao clinica do paciente neurocirurgico, particularmente nos casos de edema pulmonar nao cardiogenico

[Guillain-Barré syndrome simulating hernia of lumbar disc. Report of a case]. / Síndrome de Guillain-Barré simulando hernia de disco lombar. Registro de um caso.

The case of a 52 years-old man, with typical findings of lumbar disc disease is reported. The radiological investigation was negative and albuminocytologic dissociation in cerebrospinal fluid was detected. The clinical course was similar to Guillain-Barré syndrome which was completely solved by treatment with steroids. Brief comments on clinical aspects of that syndrome are made.