Ventriculomegaly in neurofibromatosis-1. Association with Chiari type I malformation.

Two cases of von Recklinghausen neurofibromatosis with a hitherto unreported association of ventriculomegaly and a Chiari type I malformation are described. Both cases had skeletal abnormalities at the cervicomedullary junction, contributing to neurological symptoms in 1. The literature on nontumor-related ventriculomegaly in neurofibromatosis is reviewed. The Chiari type I malformation should be considered as a cause of nontumoral ventricular enlargement in patients with von Recklinghausen neurofibromatosis.

Experimental spinal cord trauma: potentiation by alcohol.

The effect of alcohol on the injured spinal cord in cats is assessed by use of a standardized trauma model at both nonparaplegic and paraplegic trauma forces. Prior administration of an intoxicant dose of ethyl alcohol resulted in a potentiation of the trauma response at the 100 gm-cm and 260 gm-cm contusion levels. No significant changes were noted at the higher trauma grades. The results suggest that alcohol acts synergistically with mechanical injury of the spinal cord to amplify the trauma response by increasing edema formation within the contused tissue. The mechanism by which this potentiation may occur ar possibly in the areas of antidiuresis and fluid retention from increased tissue hydration in alcohol-treated animals.

Pupil cycle time in optic nerve compression.

We measured pupil cycle time before and after treatment in 11 patients with compressive optic nerve disease. Nine patients had chiasmal tumors and two had optic neuropathy of Grave's disease. Pupil cycle time before treatment was abnormal in at least one eye of all patients and in each case, pupil cycle time improved or worsened in accordance with the response to treatment of the patient's visual acuity and visual fields. This suggests that the pupil cycle time may be used as a simple objective office test for following up patients with impaired optic nerve conduction as the result of optic nerve compression. This information is similar to that gained from visual evoked response and may be used together with other objective clinical data such as disk pallor, nerve fiber loss, and relative afferent pupillary defect.

Locked-in syndrome caused by a solitary pontine abscess.

The clinical and pathological findings in a patient with locked-in syndrome caused by a solitary pontine abscess are reported for the first time. Successful treatment of brainstem abscess rests on early and accurate diagnosis.

Coexistent empty sella and prolactin-secreting microadenoma.

The empty sella turcica may be found in people with no antecedent history of intracranial disease, as well as in those with known pituitary pathology or following therapy to the pituitary gland. We have evaluated 3 women with galactorrhea and hyperprolactinemia, 2 of whom had amenorrhea. Each had an empty sella. In all cases polytomograms demonstrated asymmetry of the sella floor with focal bony erosion, conventional pneumoencephalography showed intrasellar air, and polytomographic pneumoencephalography confirmed air limited to one side of the pituitary fossa with tumor and/or residual normal tissue on the opposite side. In 2 patients who had extensive endocrine evaluation, pituitary function was normal with the exception of hyperprolactinemia. Transsphenoidal excision of microadenomas resulted in postoperative normalization of the serum prolactin concentration and resumption of regular menses in the previously amenorrheic women.

Radiographic diagnostic evaluation and surgical treatment of multiple cerebellar, brain stem, and spinal cord hemangioblastomas.

Multiple hemangioblastomas of the central nervous system present a greater challenge in their diagnosis and treatment than do single hemangioblastomas of the cerebellar hemisphere. Improved radiographic techniques of tomographic vertebral angiography and computed axial tomography (CT) are of considerable value in the diagnosis of multiple cerebellar, brain stem, and spinal cord hemangioblastomas. Microsurgical techniques now allow for total operative removal of many of these lesions. A case report is presented to emphasize the radiographic diagnostic evaluation as well as the microsurgical technique for removal of multiple central nervous system hemangioblastomas.

The development of intramedullary cavitation following spinal cord injury: an experimental pathological study.

It is concluded from this investigation that localised intramedullary cavitation will develop following non-disruptive spinal cord trauma if the magnitude of original trauma and resulting vascular damage is sufficient. Although an adhesive arachnoiditis also occurs with similar amounts of trauma, the initial vascular damage and subsequent reparative changes within the spinal cord appear to adequately explain the cavitation observed.