[Blunt injury to the neck caused by a seat belt. Stenosis of the internal carotid and vertebral arteries]. / Stumpfes Halstrauma durch Sicherheitsgurt. Stenosierung der A. carotis interna und A. vertebralis.

A 37-year-old woman sustained blunt trauma to the neck from a seat-belt in a car accident, which resulted in marked long-segment narrowing of the internal carotid artery with secondary occlusion of a main branch of the median cerebral artery as well as circumscribed circular stenosis of the right vertebral artery. Serial angiograms documented the course until there was almost complete recanalization of all affected vessels.

[Cerebral venous and sinus thrombosis (author's transl)]. / Hirnvenen- und Sinusthrombose. Diagnose und Verlaufskontrolle der Antikoagulantientherapie durch Computertomographie.

In a 38-year-old patient who had taken oral contraceptives for several years partial thrombosis of the superior sagittal sinus and cortical veins occurred. Progress could be observed with the computer assisted tomography (CAT). CAT showed multiple localised intracerebral haemorrhages fronto-occipitally and penetrating deep into the white matter. In view of the severity of morphological changes the ability for regression of such haemorrhages is surprising. This equally applies to subsequent restitution without substantial visible defects in cerebral parenchyma following treatment with heparin. Among the presentations of sinus and central venous thromboses in CAT, the empty triangle or delta sign and the cord sign should be mentioned.

PIP: In a 38 year old patient who had taken oral contraceptives for several years, partial thrombosis of the superior sagittal sinus and cortical veins occurred. Progress was observed with the computer-assisted tomography (CAT). CAT showed multiple localized intracerebral hemorrhages fronto-occipitally and penetrating deep into the white matter. In view of the severity of morphological changes, the ability of these hemorrhages to regress is surprising. This applies equally to subsequent restitution without substantial visible defects in cerebral parenchyma following treatment with heparin. Among the presentations of sinus and central venous thromboses in CAT, the empty triangle or delta sign and the cord sign should be mentioned. (author's)

[Highly located transverse lesion of the cord with quadriplegia caused by giant cell arteritis (author's transl)]. / Hohes Querschnittssyndrom (C4) durch Riesenzellarteriitis (Arteriitis temporalis) Horton.

This is a report of a 64 years old patient who experienced a transverse lesion of the spinal cord with quadriplegia caused by giant cell arteritis. It is stressed that giant cell arteritis not only affects the temporal arteries but on principle any other artery of the body. The giant cell arteritis generally is accompanied with similar humoral findigns as a malignant neoplasm. Therefor in a few cases with high spinal cord lesion suspected to be caused by a malignant tumour the giant cell arteritis may be the real cause, if a spinal mass is excluded. In order to prevent irreversible paralytic defects a cortisone therapy has to be started with as early as possible. It must be carried on for a long period to prevent a restarting of the inflammatory process.

Unsuccessful treatment with levodopa of a parkinsonian patient with calcification of the basal ganglia.

A patient aged 67 had suffered from hypoparathyroidism (tetany and cataracts) following thyroidectomy at the age of 20, although treated with AT 10. During the last few years there had been a change of gait to small steps and general retardation. Nocturnal epileptic attacks occurred in the last year which led to the admission to hospital where a well developed parkinsonian syndrome without tremor was observed. X-rays of the skull, including computed tomograms, revealed calcification of the basal ganglia and dentate nuclei. Treatment with levodopa was ineffective. The mechanism for this is discussed.

[Radiation myelopathy-two cases with unusual development (author transl)]. / Strahlenmyelopathie--Zwei ungewöhnliche Verläufe.

This is a report of two women who experienced radiation myelopathy 2,5 and 9 months after telecobalt radiation. Tetraplegia and paralysis of the inspiratory muscles developed rapidly in the first case whereas in the second case the paralysis and the initial Brown-Sequard syndrome improved after treatment with corticosteroids and infusion of Rheomacrodex and Sorbit. It should be stressed that in both cases the radiation stress on the spinal cord was under the limit of tolerance of 3300 to 4000 R. The differential diagnosis of radiation myelopathy from spinal metastasis is most important because the treatment is different for each conditions.

[Nonaneurysmal vascular pressure lesions of the cranial nerves (author's transl)]. / Nichtaneurysmatische gefässbedingte Druckläsionen von Hirnnerven

Four cases of facial spasm and 1 case of oculomotor paresis are described. The source of the disorder in all 5 cases is mostlikely not an aneurysm of the vessels of the base of the brain. The literature is discussed and thereby it is shown that mechanical disturbances of other cranial nerves (II, V, VI, IX, XII) can be caused by similar vascular (nonaneurysmal) abnormalities.