Prevention of death from head injury in Natal.

A detailed review of 100 consecutive head injury deaths in the Natal area was undertaken after forensic autopsies had been performed; neurohistological examination was carried out in 69 cases. It was found that one-third of deaths could have been prevented by medical treatment. Hypoxic and ischaemic brain damage was judged to be a contributing cause of death in 88% of all victims. Factors isolated as major causes of preventable death included: failure to prevent hypoxic brain damage by timeous endotracheal intubation and rapid resuscitation; major delays in referral from feeder hospitals; and failure to detect intracerebral haematomas and contusions which subsequently caused raised intracranial pressure. Recommendations for improving this situation are discussed, with particular reference to the situation in Natal.

Praziquantel (pyrazinoisoquinolone) in active cerebral cysticercosis.

A prospective open therapeutic study on volunteers with active neurocysticercosis using pyrazinoisoquinolone (Praziquantel) has shown that it is a safe and effective drug. Objective assessment of the effect of treatment was by high resolution sequential computed tomographic scanning. Sixty-six patients received the drug. Forty-one records were available for complete analysis at the end of 1 year of follow-up. The concomitant use of steroids reduced side effects significantly. A 98% improvement was achieved.