Cervical dermal sinus and intramedullary spinal cord abscess: case report.

Congenital dermal sinuses in the cervical region are rare. A case report is presented in which the persistent anomaly led to formation of an intramedullary spinal cord abscess. The clinical presentation, radiological diagnosis, and surgical management are discussed.

Hemiballismus-hemichorea treated with dimethylaminoethanol.

An elderly lady with subacute onset of disabling hemiballismus experienced sustained remission on dimethylaminoethanol 150 mg/day. Two exacerbations followed interruption of therapy. Remission followed resumption of therapy. No undesirable side effects occurred with this treatment. A lady age 85 experienced a very favorable sustained reduction of hemiballismus when treated with dimethylaminoethanol (DMAE or Deanol). Her age and hypertension made the risk of thalamotomy unacceptably high. DMAE was tried because of reports of reduction of chorea, and other dyskinesias with this drug.

Closed head injury: a simplified approach.

In early evaluation of the head-injured patient one must continuously be alert for signs requiring operative intervention. If a neurologic deficit is in evolution, it should manifest itself by producing a change which will not be missed by careful frequent clinical evaluation.

Melanin as a component of cerebral gliomas: the melanotic cerebral ependymoma.

Even though melanin is found in certain central nervous system neurons and leptomeningeal melanocytes, gliomas rarely possess melanin. A few rare lethal melanotic medulloblastomas found typically in the cerebellar vermis of children have been described, but neuroglial cells have not been observed to contain this pigment. Since glial elements and the melanotic pigmented layer of the retina are derived from the same ciliated epithelium of the embryonic neural tube, recognition of melanin in a cerebral glioma was predictable. Indeed, melanin was observed in a cystic cerebral ependymal glioma from a 30-year-old woman, supporting the potential of glial cells to produce melanin.

Bioavailability and single-dose pharmacokinetics of intramuscular phenytoin.

Comparison of phenytoin plasma concentrations in an intravenous and intramuscular crossover study in 12 healthy ambulant, male subjects indicates that phenytoin administered intramuscularly is absorbed over a period of approximately five days. A model simulating precipitation and redissolution of the drug at the injection site has been shown to satisfactorily fit observed plasma concentration data following intramuscular administration. It is proposed that this model will be useful in the selection of an appropriate dosing regimen in situations in which intramuscular administration of phenytoin is indicated.

Early post-traumatic epilepsy prophylaxis.

An anticonvulsant regimen is described using diphenylhydantoin specifically designed for use in the acutely head injured patient. Initial doses of diphenylhydantoin based on body weight and maintenance doses determined by plasma concentrations of the drug are utilized to provide immediate and maintainable anticonvulsant blood levels.