Thalamic syndrome caused by unruptured cerebral aneurysm. Case report.

A case is reported of a 63-year-old woman with thalamic syndrome as the presenting feature of an unruptured cerebral aneurysm. Unruptured aneurysm is a rare cause of thalamic syndrome; the possible mechanisms of production of the sensory disturbance are discussed.

Pontomedullary tear in a speedboat accident. Report of a case with MRI diagnosis.

A case of atlanto-occipital dislocation with incomplete pondomedullary brainstem tear is reported; it resulted from a high-speed motorboat accident. The 43 year old man exhibited a locked-in syndrome; the diagnosis was made with MRI and verified by autopsy. With modern methods of life support, prolonged survival after such injuries is unfortunately sometimes possible.

Optic nerve apoplexy. Report of two cases.

Two patients who suffered loss of vision due to spontaneous optic nerve hematomas are described. The hemorrhage was contained within the pial confines of the involved optic nerve, although there was some extension more posteriorly. The diagnosis of an intraneural cryptic arteriovenous malformation was histologically confirmed in one case and was supported by evidence in the other. Surgical evacuation by the subfrontal approach was undertaken and visual function improved.

Extradural haematoma in children. Primary and secondary lucid intervals.

Twenty-six cases of extradural haematoma in children were reviewed over a 10-year period. The incidence of extradural haematoma was 3.3/1000 patients admitted to hospital with head injuries. Of 26 patients, 23% had no skull fracture and, in a further 8%, the fracture was not radiographically detectable. Twenty-three per cent of patients showed papilloedema, and 50% exhibited a fixed dilated ipsilateral pupil. In 62% of patients, there was no initial loss of consciousness; in a further 19%, impairment of consciousness was brief or doubtful. The lucid interval lasted three hours or less in one-third of patients; 24 hours after injury, the level of consciousness had declined in 73% of patients. Of particular interest was the occurrence of a secondary lucid interval, definite and dramatic in 8% of patients, and definite, but slight, in a further 12%. All patients made a good recovery, except one, who died from massive pulmonary fat embolism.

Muslin wrapping of aneurysms and delayed visual failure. A report of three cases.

This article reports three cases of visual failure of presumably ischemic etiology, after aneurysm surgery; the first case occurring 7 months after clipping and gauze wrapping of a 4-mm anterior communicating artery aneurysm; the second case occurring 8 months after gauze wrapping of a partially intracavernous 10-mm internal carotid artery aneurysm which projected into the right optic foramen; and the third case occurring 11 months after ligation, clipping, and gauze wrapping of an 8-mm internal carotid-posterior communicating artery aneurysm.