[Treatment of vasospasm in aneurysmal meningeal hemorrhage using intravenous nimodipine. Multicenter cooperative study].

We present a multicentric randomized double-blind study of the curative effect of intravenous Nimodipine on the post hemorrhagic vasospasm after aneurysmal rupture. On 122 validated cases out of 188 analyzed patients, the study demonstrates a significative effect on the mortality and severe morbidity related to vasospasm: the reduction of the risk is appreciated to 72%. The major effect is obtained on the mortality risk.

[Secondary hematoma of the brain stem. Apropos of 5 cases].

Five cases of brain-stem hematoma are described. The cause of these hematomas was identified as "cryptic angioma" (1 cavernous angioma, 1 telangiectasia, 3 arteriovenous malformations). So, they are so-called "secondary hematoma", as opposed to brain-stem hematoma in relation with hypertension.

[The place of arteriography in the etiologic diagnosis of spontaneous intracerebral hematomas].

456 cases of spontaneous cerebral hemorrhage have been referred at the Neurosurgical Department of the University of Rennes since the CT scan is available, i.e. from 1979 till 1984.

Extracorporeal circulation with deep hypothermia and circulatory arrest in the treatment of intracranial arterial aneurysms.

Extracorporeal circulation with circulatory arrest and deep hypothermia in surgery on certain giant intracranial arterial aneurysms or on aneurysms difficult to access is described. The series includes a giant left carotid aneurysm, an aneurysm of the basilar artery bifurcation, a patient with two aneurysms, one on the right middle cerebral artery and the other at the end of the basilar artery, and a fourth patient with two aneurysms, one on the right middle cerebral and the other on the right carotid. Closed-thorax extracorporeal circulation with femoral cannulation was performed on all the patients.

[Benign intracranial hypertension in polycythemia which had caused a lateral sinus thrombosis].

Report of a case of so called "benign" intracranial hypertension whose main characteristics are: the etiology attributed to a thrombosis of the venous transverse sinus in the course of a polycythemia; the clinical signs with a reinforcement during the course of the illness of a previous epilepsy; the prognosis with specially heavy visual impairment questioning the prefix "benign" applied to this condition.

[Syringo-peritoneal shunt].

The pathogenesis of syringomyelia is still under discussion. The authors advocate the role of the pressure of the spinal C.S.

Spinal cord compression by extradural fat after prolonged corticosteroid therapy.

This young man was operated on twice for thoracic spinal cord compression. He had been on corticosteroid therapy for the last 2 years subsequent to a renal transplant. The only anomaly discovered during the operation was a large quantity of extradural fat that did not present the characteristics of lipoma.

Extra-intracranial anastomosis using a venous graft.

The authors describe a patient with ischaemic neurological incidents due to bilateral hypoplasia of the carotids. Because the use of the superficial temporal artery or the occipital artery was impossible, the extra-intracranial anastomosis was performed by a direct venous graft between the external carotid artery and the posterior temporal artery. The authors describe and illustrate the operation, emphasizing the particular difficulties due to differences in diameter of the arteries and the graft.

[The place of surgery in the treatment of supra-tentorial malignant gliomas (author's transl)].

The natural history of malignant gliomas is compared to the mean survival duration after surgery alone and/or surgery associated with radiotherapy and chemotherapy. In the state of the art a combined treatment by surgery and roentgentherapy offers the best prognosis but does not allow for more than 35% of expectation of life at the end of the first year. According to the severity of the general prognosis the present authors advocate a strict care for the functional integrity.

[Cerebral aneurysms complicating bacterial endocarditis. Seven cases (author's transl)].

The authors report seven cases of cerebral aneurysms complicating bacterial endocarditis. The evolution was good in three cases, two of which without sequelae. The bacteries involved were staphylococcus, streptococcus, and enterobacter.

[Lateral interscalenic approach for tumors of the cervical intervertebral foramina (author's transl)].

The authors report six cases of tumours limited to the cervical inter-vertebral foramen. The patients presented with cervico-brachial neuralgias occasionally accompanied by radicular sensitivo-motor impairment. Radiographs and tomographs of the cervical spine demonstrated enlargement of the intervertebral foramen with bone proliferation depending on the etiology and provided in easy diagnosis in all the cases.

Treatment in tumours of the pineal region: value of sterotaxic biopsy.

The treatment of tumours of the pineal region is the subject of keen controversy between advocates of surgical excision and those of radiotherapy with ventricular shunting. The proponents of these extremes often seem to ignore the wide pathological variety of tumours of this site. Attempted excision of a germinoma invading the walls of the 3rd ventricle is as futile and dangerous as irradiation of a teratoma.

[Nerve grafts. Experimental study. Importance of number of suture points (author's transl)].

An experimental study about 36 nervous grafts on laboratory rats is reported. This study emphasizes the interest of microsurgical technique and, further more, the role of the number of stitches improving the results of each anastomosis and, thus, the quality of neural regeneration. In each animal, after sectioning tibial nerve, a graft (sciatic nerve same side) is interposed and sutured in three different ways; in a first lot of animals 6 stitches at the level of each anastomosis; in a 2nd lot: 2 stitches and in a 3d one a single stitch.

[Arguments in favor of the genetic origin of malformed syringohydromyelic pictures].

After a critical analysis of the criteria usually used for arguing in favor of the hydrodynamic determinism of the syringohydromyelic malformations, the authors report convincing data according to which such dysmorphic status would be the result of abnormalities in the genetic programs of the morphogenesis of the central canal.