[Arteriovenous malformations of the dura mater]. / Malformacje tetniczo-zylne opony twardej mózgu.

The authors present two cases of dural arteriovenous malformations treated in Dept. of Neurosurgery, Warsaw Medical School. The main clinical problems of this type of AVM are discussed.

Neuropathological changes in resected temporal lobe of patients with cryptogenic epilepsy.

The study was performed on cerebral tissue resected during temporal lobectomy in 16 patients whose long-standing cryptogenic epilepsy did not submit to anticonvulsive drugs. Cases presenting definite etiological factors such as CNS trauma, infection or neoplasm were excluded. Neuropathological investigations disclosed microangiomas and focal vascular malformations in the meninges and tissue in 7 patients. Neuronal heterotopias in the white matter and of the white matter in the cortex were observed in 3 cases. Main cortical changes were: neuronal loss, chronic neuronal degeneration, perineuronal satellitosis, and GFAP-positive submeningeal gliosis, especially at the bottom of sulci, perivascular gliosis and laminar or diffuse gliosis. The changes in the hippocampus were most enhanced in the end-plate and in the sector H3 of the pyramidal layer. Astrocytic gliosis in the white matter presented distinct GFAP and S-100 immunostaining; the latter involved in some cases a wider area than the GFAP reaction. The above named changes are analysed with regard to the presumed epileptogenic factors and to the postepileptic damage.

The results of the surgical treatment of occipital lobe epilepsy.

Out of 502 patients with surgically treated drug-resistant chronic epilepsy (tumour cases excluded) in 12 (2%) a clear occipital focus was found. The pattern of seizures was in most cases nonspecific and polymorphic. EEG examination and neuroradiological findings led to proper localization of the epileptogenic focus. Partial or total occipital lobectomy was performed. Follow-up from 4 to 20 years revealed a satisfactory result in 11 of the surgical cases. One patient was lost to follow-up. Brain scarring was found in the histological examination of specimens in 9 out of 12 patients. The results of the surgical treatment of occipital lobe epilepsy are much better than in other localizations of epileptogenic foci.

[Value of testing vibration sensation in diagnosing spondylogenic pain syndromes]. / Wartosc badania czucia wibracji w rozpoznawaniu spondylogennych zespolów bólowych.

One-hundred patients with cervical vertebral changes, 100 with lumbar vertebral changes and 20 with ankylosing spondylitis were studied carrying out examinations of the sensation of touch, pain and vibration in these dermatomes and sclerotomes which are related to the levels of the most frequently occurring intervertebral disc changes. It was found that disturbances of the vibration sensation occurred significantly more frequently than disturbances of surface sensitivity, and their character suggested that they were a more specific sign of damage to the innervation of the spine than segmental disturbances of superficial sensitivity which are due to root damage.

[Clinical picture of diskopathy in patients with narrow lumbar spinal canal]. / Obraz klinikczny dyskopatii u chorych z waskim kanalem kregowym odcinka ledzwiowego.

In a group of 400 patients operated upon at the Department of Neurology, Institute of Rheumatology in Warsaw in the years 1971-1978 for lumbar intervertebral disc prolapse in 20 cases (5%) canal stenosis was found as the cause of vertebral canal narrowing. Three clinical syndromes were isolated in this group: cauda equina intermittent claudication (4 cases), flaccid paraparesis of lower extremities (3 cases) and ischialgia with paralysis of an extremity (13 cases). The clinical and radiological features and pathogenetic factors in stenosis of the lower part of the vertebral canal are discussed. The good results of vertebral canal decompression are stressed.

[Evaluation of the results of conservative and surgical treatment of lumbar diskopathy]. / Katamnestyczna ocena wyników zachowawczego i chirurgicznego leczenia dyskopatii ledzwiowego odcinka kregoslupa.

The authors analysed 300 inquiry responses from patients with lumbar discopathy treated conservatively and surgically at the Department of Neurology, Institute of Rheumatology in Warsaw in the period from Jan 1 1971 to Dec 31 1976. A significant proportion of patients (86%) reported a good result of this treatment persisting for many years. Seventy-five per cent of patients treated here returned to their previous occupation. In a comparative analysis of the conservatively and surgically treated cases the results of surgical treatment were found to be evidently better which suggests a need for extending the indications to surgical interventions. The authors conclude that effective conservative or surgical treatment in hospital has an additional favourable psychological influence on the patients, and maintenance of good therapeutic results many years after hospital treatment depends on posthospital systematic medical care which influences the further fates of the patients.