[Migration of subduro-peritoneal shunt into the subdural space of an infant (author's transl)].

A ten-month-old baby was admitted to our clinic with the diagnosis of bilateral chronic subdural hematomas. He had complained of general convulsion during the past 3 months. Evacuation of hematomas was performed on both sides through burr holes in the parietal region. Several weeks following the evacuation of hematomas, subduroperitoneal (S-P) shunting operation was further performed bilaterally for the collection of fluid in the subdural spaces, using a "Pudenz" shunting catheter with a reservoir. The catheter was fixed at the connector of the reservoir and the peritoneal catheter by several silk sutures to the epicranium. Three weeks after S-P shunting operation the right shunting system was not felt on his head on palpation, and the abnormal high density spots were shown inside the right subdural space on CT. The right craniotomy revealed that the whole shunting system was located in the right subdural space. Technical problems of the shunting operation and the several factors of the patient which may contribute to such a rare complication of this surgical procedure are briefly discussed.

Giant cell tumor of the skull.

A 23 year-old female had a giant cell tumor originating in the right temporal bone. A diagnosis was maed by biopsy. Microscopically it was sarcomatous in part. Two courses of radiation therapy, each total dose being 6000 rads and 3000 rads in air, were employed with good subjective response for a short duration. However, the tumor involving the petrous bone and the mastoid process extended, invading the epipharynx and the clivus. The patient died one year after onset.

[Primary osteosarcoma of the skull--a case report (author's transl)].

A case of primary osteosarcoma of the skull is reported in this paper. The patient was a 41-year-old male, who complained of painless swelling of the left upper eyelid and became unable to open his left eye. He was admitted to our hospital on March 27, 1972. A bony hard tumor, fingertip in size, was palpable subcutaneously at the left superior orbital margin. The tumor was inmovable and not tender. Ophthalmological examinations of the left eye revealed disturbance of upward ocular movement without exophthalmos. The ocular fundus showed slight dilatation of the retinal veins and the normal disc. The visual acuity and the visual field appeared intact. X-ray films of the skull showed irregular osteolytic changes in the left orbital roof and the superior orbital margin. Left carotid angiogram showed abnormal vessels forming pools and arterio-venuous fistulae in the osteolytic lesion. An April 5, 1972, surgical removal of the tumor was performed successfully and the dura attached to the tumor was also excised. After operation, chemotherapy and radiation therapy were applied. Histological examination showed osteosarcoma invading the dura. At present, two years and seven months after surgical treatment, the patient is doing well without evidences of recurrence of this disease.

[An autopsy case of pinealoma treated by irradiation about four years ago (author's transl)].

The patient was a thirty years old male, who was diagnosed as having pineal body tumors in June,1969, and treated by irradiation after a ventriculo-atrial shunt operation. He recovered well, and participated in some simple work. In May 1972, he suddenly had convulsions followed by incontinence, and he became nearly apallic. Neuroradiological examinations revealed the presence of left frontal tumor, which was removed, on June 22, 1972. Histological examinations of the tumor proved to be pinealoma of two-cell pattern. Though improved slightly after operation, he became apallic again, developed pneumonia, and died on February 22, 1973.