Results of surgical treatment of neurocysticercosis in 69 cases.

The clinical course of 69 patients with neurocysticercosis who underwent surgery to control increased intracranial pressure (ICP) or cyst removal is analyzed. Increased ICP was caused by hydrocephalus in 63 patients, by cerebral edema in four, and by giant cysts in two. Skull x-ray films showed calcifications in 14% and signs of elevated ICP in 46%. Examination of cerebrospinal fluid (CSF) revealed pleocytosis with eosinophils in 52% of cases and a positive complement fixation test for cysticercosis in 66%. Ventriculography allowed localization of the CSF obstruction and ventricular cysts, and generally differentiated between an obstruction due to cysts and an inflammatory process. Computerized tomography showed cysts in the cerebral parenchyma and ventricular dilatation. Ventricular cysts were best seen when intraventricular metrizamide was used. Intracranial shunting and posterior fossa exploration were less effective in the treatment of hydrocephalus than was ventriculoatrial (VA) or ventriculoperitoneal (VP) shunting, although VA or VP shunting was associated with a high percentage of complications. Quality of survival was good in 87% of the cases in the first 3 postoperative months and in 93% of patients who survived 2 years after surgery. Forty-seven patients (68%) were readmitted one or more times for CSF shunt revision; 14 of them for shunt infection (meningitis). The early operative mortality rate was 1.8% for patients with VA or VP shunt placement and 5.3% for those with posterior fossa exploration. The authors conclude that placement of CSF shunts is indicated in the treatment of hydrocephalus, and cyst removal is indicated only when the cyst exhibits tumor-like behavior. Surgical exploration is also indicated when the diagnosis is uncertain.

[Hypothalamic stimulation effects on duodenal motility of rat. IV) Vias hypothalamo-duodenal (author's transl)]. / Efeitos da estimulacão hipotalâmica sobre a motilidade duodenal do rato. IV) Vias hipotálamo-duodenais

UNLABELLED: Changes in duodenal motility, induced by electrical stimulation of hypothalamus, have been studied in rats, and registered by the baloon method. Localization of stimulated points was made by stereotaxic method, or by hostological control. Four animals were previously adrenalectomized. In 13 rats, the experiment has been repeated after bilateral cervical vagotomy. In 5 animals after total spinal cord transection, in the first dorsal segment. In 7 rats the experiment was reproduced after venous injections of atropine solution. In 5 rats after venous injections of dibenamine solution, and in other 5, after venous injection of hexamethonium solution. CONCLUSIONS: 1) Impulses that produced excitatory duodenal effects were mediated by the vagi nerves. 2) Impulses that produied inhibitory duodenal effects were not transmitted by the vagi nerves, but by sympathetic pathways.