[Pituitary adenoma secreting prolactin. Results of their surgical treatment].

A retrospective study of 75 patients operated for pituitary prolactin-secreting adenomas between 1972 and 1992 is presented. 57 were women, 18 males. The major symptom was amenorrhea for women and impotence for men.

Migration of purified embryonic motoneurons grafted into adult mouse CNS.

Embryonic motoneurons were fluorescently-labelled with carbocyanine (diI) by means of retrograde transport and then grafted into the adult mouse spinal cord (L2) and brain (striatum) for 2-10 weeks. The motoneurons were grafted either following purification on the fluorescence-activated cell sorter or in the presence of embryonic glial cells and interneurons from the spinal cord. In both conditions of grafting, motoneurons were found to survive and develop in both grey and white matter and were found to migrate long distances in both regions of the central nervous system.

Intraoperative electrically evoked vestibular potentials in humans.

Electrically evoked short latency vestibular potentials were recorded in 9 patients during vestibular neurectomy. Patients were operated on because of intractable Meniere's disease. The VIIIth cranial nerve was exposed through a limited retrosigmoidal approach; the vestibular nerve was contacted in the cerebello-pontine angle with a bipolar platinum-iridium electrode and stimulated with biphasic current pulses (100 microseconds/phase, 0.

Phase II study of tauromustine in malignant glioma.

46 eligible patients with either anaplastic astrocytoma (AA) or glioblastoma (GBM) and clinical and computed-tomography-confirmed relapse following primary surgery and radiotherapy received oral tauromustine 130 mg/m2 every 5 weeks. A prospective design allowed for concurrent assessment of both clinical and radiological responses and drug toxicity. 41% of patients improved clinically whilst 46% improved radiologically with 3 complete, 7 partial and 7 minimal responses (WHO criteria).

Sudden cervical pain: spontaneous cervical epidural hematoma.

Three cases of cervical epidural hematoma are reported. Acute neck pain usually associated with a mild effort, closely followed by radicular pain and a neurologic deficit below the lesion is the typical presentation of this extremely rare and difficult diagnosis. As prognosis depends on preoperative neurologic state, the authors emphasize the importance of prompt identification of this lesion.

Embryonic motoneurons grafted into the adult CNS can differentiate and migrate.

Embryonic mouse motoneurons were labelled by retrograde transport with a fluorescent dye (diI), partially purified on a density gradient and grafted into adult mouse CNS for a maximum of 10 weeks. In both the spinal cord and striatum, a small number of fluorescently labelled motoneurons were found to survive as judged by their round, bright appearance and also to differentiate as assessed by their ability to extend neurites. The motoneurons travelled long distances in the spinal cord (2 mm) and in the brain (4 mm) in both white and grey matter.

Grafting of embryonic motoneurons into spinal cord and striatum of adult mice.

The aim of the present work was to determine whether embryonic motoneurons could survive in the adult CNS and whether they display different survival and growth characteristics in their natural site (the spinal cord) as compared to an ectopic site (the striatal region of the brain). Specific labelling of embryonic motoneurons was obtained by retrograde transport of a fluorescent tracer (carbocyanine) followed by partial purification of the dissociated motoneurons on a density gradient. This technique offers the advantage that only the motoneurons in the cell suspension used for the grafts contain the fluorescent tracer.

Radicular compression due to lumbar intraspinal gas pseudocyst: case report.

A case of sciatic pain syndrome is reported. Computed tomography showed evidence of gas in the spinal canal, and at operation a gas-filled pseudocyst was found in the spinal canal, without herniated disc. The cause of this unique case is discussed in relation to the spinal vacuum phenomenon.

Protein analysis of subdural hygroma fluid.

The pathogenesis of posttraumatic subdural hygroma still remains largely unknown. One of the suggested pathological mechanisms is the traumatic development of an arachnoid tear and the subsequent efflux of CSF into the subdural space. We performed a multifactorial analysis of the hygroma fluid obtained at operation in comparison to the simultaneously taken plasma and lumbar CSF.

Acute subdural and subgaleal empyema.

A case is presented in which the initial CT scan failed to demonstrate subdural suppuration over both convexities. Definitive CT finding of subdural empyema (SDE) was only positive at an advanced stage, when a bilateral subgaleal empyema also spread out. Because of the fulminant development of the subdural empyema and the delayed diagnosis, the outcome was fatal in spite of neurosurgical operation.

[Complementarity of x-ray computed tomography of staged stereotaxic biopsies and of stereo-electroencephalography in the spatial definition of intracranial lesions].

This study concerns 180 patients (132 M; 48 F) (age: 2 to 69 years; m: 33 years) who underwent stereotactic procedures according to the methodology of Talairach and Szikla. Such procedures (stereotactic and stereoscopic angiography in all cases, and ventriculography in 81%) should permit a correct spatial definition of intracranial lesions. The informations provided by the angiography (normal in 7%) and by the ventriculography (normal in 11%) are complementary to those yielded by the TDM and permit an easier and safe stereotactic approach to the lesions.

[Value and technic of translating the data from x-ray computed tomography into the stereotaxic coordinates of the Talairach system].

The neuroradiological stereotactic examinations provide indispensable information to localize many intracranial lesions: the data obtained by the CT-Scan are complementary of the stereotactic ones. The transfer of the routine CT-Scan transverse axial slices into the Talairach stereotactic system needs a precise definition of the inclination of the plan of the slices and a correct evaluation of the mean magnification factor. The inclination of the slices is appreciated using the bony, vascular and ventricular landmarks clearly identified on the CT-Scan and stereoscopic stereotactic images.

[Post-traumatic intracerebral hematoma].

The clinical and therapeutic features of 18 delayed traumatic intracerebral hematomas (DTICH) were compared with those of 84 primitive traumatic intracerebral hematomas in order to determine the origin of this complication. This retrospective study found that: DTICH usually occurs the first week after trauma, but could happen several weeks later; patients with skull fractures are at higher risk (p less than 0.01); osmotherapy as well as barbiturate therapy seem to have no influence on this complication; craniotomy (or craniectomy) appears to be a significant factor in the cause of DTICH (p less than 0.

Intracerebral ganglioglioma.

Ganglioglioma in the temporal lobe was encountered in 0.6% of a series of 998 patients undergoing biopsy for intracranial tumors. It was more frequent in young adults and children.

The clinical course of surgically treated posttraumatic subdural hygromas.

The clinical course of 11 patients with a subdural hygroma, who underwent neurosurgery, was studied. In the first week after the operation no improvement of the mental status could be detected. We considered therefore that operation hardly contributed to improvement.

[Thalamic pain syndrome. Clinico-radiologic correlations and treatment by intermittent stimulation of the sensory nuclei of the thalamus].

The thalamic pain syndrome is classically due to a softening of sensory thalamic nuclei. In a series of 10 patients treated between 1977 and 1984 by the intermittent stimulation of the nuclei ventroposterior thalami, the CT-Scan showed in 7 cases the thalamic lesions and in 3 cases a parietal one. The clinical manifestations of theses 2 groups can be individualised.

Dystonia caused by putamino-capsulo-caudate vascular lesions.

Three cases of unilateral dystonia of vascular origin are presented and compared with those in the literature. Damage in the region of the lenticulostriate arteries accounted for ischaemic lesions of the putamino-capsulo-caudate region, the external pallidum probably also being involved. This syndrome appears if the ischaemic accident took place during childhood.

[Intracranial metastases of cancer of the prostate].

In Geneva at autopsies, 4.8% of the cranial cavities contained metastasis of any origin (872 cases in 19 years), which in 21 cases was prostatic (2.4%).

Recurrent alternating ophthalmoplegia with iridoplegia in a young diabetic.

Regressive painless left third nerve paralysis with pupillary involvement was followed 6 months later by a right painful complete ophthalmoplegia. The two attacks resolved without treatment. The patient, 22 years old, was recognized diabetic and no other cause was found.

[Paralysis of the IIIrd cranial nerve. Pain and its value in the differential diagnosis (author's transl)].

Eighteen cases of paralysis of the IIIrd cranial nerve are studied, 9 of which were of ischemic origin (diabetes, hypertension or arteriosclerosis), and 9 secondary to aneurysm of the posterior communicating artery. Seven patients from the first group and all of the second suffered from headaches. This study deals essentially with the associated painful symptom, its localisation, its nature and its value in the differential diagnosis of the two conditions.