Clinical and anatomical observation of a patient with a complete lesion at C1 with maintenance of a normal blood pressure during 40 minutes after the accident.

The authors report on their clinical observations concerning a patient with a complete spinal cord injury at the level of C1, followed by a cardiac hypoxic arrest, due to immediate respiratory paralysis after the accident. Normal cardiac activity was obtained as a result of rapid resuscitation measures, using only intubation and external cardiac massage without any drug administration. The blood pressure was maintained without any drugs at a level of 130 Torr during 40 minutes before it fell to a permanent level of 50--40 Torr on ventilation alone. The diagnosis during the first hours was believed to be that of an irreversible coma with no evidence of vertebral injury. The patient started to recover consciousness after a few days but died on the 15th day. The case is discussed in the light of the literature and of the recent physiological experiments concerning the rapid changes of blood pressure after spinal cord section in animals.

[Intracerebellar schwannoma]. / Schwannome intra-cérébelleux.

Only some rare examples of schwannomas localized in the medullary parenchyma are cited in the literature. The first was described by Kernohan in 1933; 9 cases were rapported in the thirty following years. For Brain a few observations about one case were cited by David (1965), Gibson (1966), New (1972) and Ghatak (1975). The authors relate one case of isolated schwannoma in superior vermis. That was a 15 years old young man who had a low evoluting I.C.P. syndrome. The pre-operating neurological investigation revealed a small cerebellar syndrome. The neuroradiological record allowed to localize an expansive median affection in the posterior fossa on a level with the Sylvius aqueduct. The neurosurgical operation allowed to carry off a tumor from the superior vermis; schwannoma tissue was the conclusion of the histological study. The evolution has been good and no cranial nerves were involved. Different theoris about the localisation of Schwann cells in this region are described.

[Cutaneo-digital metastasis of a cancer of the buccal floor (author's transl)]. / Métastase cutanée digitale d'un cancer du plancher buccal

The authors describe the case of a patient with cancer of the buccal floor presenting with an inflammatory tumefaction of the tip of the little finger of the left hand passing for a whitlow. No cure was obtained after two lancings, and X-Rays showed lesion of the bone. Amputation revealed neoplastic tissue similar to that in the buccal floor. This cutaneous-digital metastasis is very rare, especially in cases of O.R.L. tumours.