Anal protrusion as a complication of ventriculo-peritoneal shunt. Case report and review of the literature.

A case is reported in which the Raimondi peritoneal catheter of a ventriculoperitoneal shunt spontaneously protruded from the anus in an infant. This complication has been previously reported; both pathogenesis and treatment may still represent a problem. From the review of the pertinent literature pathogenesis is mostly related to bowel perforation due to local infective adhesions.

[Interruption of antiepileptic therapy in seizure-free patients following surgery to remove the epileptogenic lesion].

This paper presents a series of 20 epileptic patients operated on at our Institute, with a clinical, EEG and drug plasma level follow-up, for periods from 48 to 60 months. Following surgery a group of 12 patients were seizure-free in a 3 year period of follow-up, and anticonvulsant medication was gradually withdrawn. While in 8 of these patients drug interruption uneventful, in 4 cases drug withdrawal caused the seizure to reappear.

Cerebral protection with diphenylhydantoin during disobliterating surgery of the sovra-aortic branches.

Cerebral metabolic protection in patients submitted to carotid tromboendoarterectomy (TEA) can be made by means of drugs, both in the clamping acute intraoperative phase and in the immediate post-operative period. The knowledge that DPH has the property of reducing CMRO2, the lactates production and of increasing the cerebral level of glucose, glycogen and phosphocreatinine, has persuaded us to use this drug instead of barbiturate, as a therapeutic protection to prevent hypoxic damages to the nervous cell. Our series include 12 patients submitted to carotid TEA in whom cerebral metabolic protection has been obtained by means of DPH at the dosage of 15-17 mg/kg body wt.