Melatonin secretion in patients with pineal region tumors-preliminary report.

Tumors of the pineal region, though not very common, are recently more often diagnosed due to the introduction of computer tomography and magnetic resonance examinations into neurosurgical practice. However many controversies about the treatment of them still exist. Some of them need aggressive treatment.

How should we manage children after mild head injury?

There are many controversies concerning the management of children after mild head injury. Most of these patients achieve a full recovery without medical or surgical intervention. A small percentage of them deteriorate owing to intracranial complications.

[Own experience with the treatment of intracranial aneurysms using "Perneczky" - Zeppelin clips].

The basic design and the mechanism of clip application have not changed for many years. However in cases of aneurysms located deeply inside brain structure, in narrow spaces, multiple aneurysms or those which require applying of several clips the surgeon may have problems with visual control of the position of the clamping arms on the neck of aneurysm, nearby blood vessels and nerve structures. The above mentioned problems motivated prof.

Surgery or conservative treatment in children with traumatic intracerebral haematoma.

In contrast to the case of extracerebral haematomas, the criteria for operative treatment of traumatic intracerebral haematoma (TIH) are not clear. The purpose of this study was to find factors that would be helpful in reaching a decision for surgical or conservative treatment of TIH. We performed a retrospective analysis of 31 consecutive cases of TIH treated in our department.

[Head injuries in pediatric age].

Head trauma is the leading cause of morbidity and death in paediatric population. The authors present an outline of contemporary knowledge on the paediatric head injury on the ground of literature and own experience. The value of Glasgow Coma Scale, its modifications and other prognostic factors in children's population after head trauma is discussed.

The prognostic value of some clinical and diagnostic factors in traumatic intracranial haematoma.

In order to carry out the analysis of predictive values of some clinical and diagnostic features, 146 patients of the Neurosurgical Clinic of the Silesian School of Medicine, were examined in 1980-1986. All the patients were in coma when admitted while CT findings showed traumatic intracranial haematomas. The examination included neurological diagnosis and CT examination.

[Results of toothlessness treatment by calottic method in the Cracow modification. Clinical studies].

The purpose of the paper was to control the new method of teeth positioning in complete dentures based on the modification of callottic method in clinical practice. Clinical studies depended on occlusion and articulation estimation, examination of denture statics, control of occlusion height and registration of the patients' subjective experiences. They concerned 81 toothless patients divided into 2 groups according to the specific classification and wearing complete dentures in which the teeth had been positioned according to the modified method and Gysi-Fischer' method.

[Results of the surgical treatment of intracranial aneurysm].

In the years 1976-1984 in the Department of Neurosurgery, Silesian Medical Academy in Katowice 196 patients were treated surgically for intracranial aneurysms. In the patients with aneurysms in the anterior part of the circulus arteriosus Yasargil's craniotomy was done. In some cases of aneurysms of the posterior cranial fossa suboccipital craniotomy was performed.

[Surgical treatment of a giant aneurysm of the middle cerebral artery].

Four patients with giant aneurysms of the middle cerebral artery over 2.5 cm in diameter were treated surgically. The aneurysms were excised during operations carried out under hypotension achieved with sodium nitroprusside, with administration of large amounts of mannitol and with arrest of blood flow in the middle cerebral artery for 3-10 minutes.

[Homovanillic acid (HVA) and 5-hydroxyindoleacetic acid (5-HIAA) levels in the cerebrospinal fluid from the lateral ventricle of patients with brain tumors].

In patients with supratentorial tumours and posterior fossa tumours or in the third ventricle the concentrations of HVA and 5-HIAA were determined in the cerebrospinal fluid from the lateral ventricle. A significantly greater concentration of HVA and 5-HIAA was found in the patients with considerable hydrocephalus caused by occlusion of the third ventricle, aqueduct or fourth ventricle as compared with the cases of supratentorial tumours and with cases of moderate hydrocephalus and partial block of fluid outflow caused by third ventricle tumorous or posterior fossa tumours.

[Subarachnoid hemorrhage in acoustic neuroma].

A 32-year-old patient is reported with two subarachnoid bleedings occurring at an interval of 5 years. The cause of bleeding was a richly vascularized neurinoma of the acoustic nerve with focal necrosis. Operation was successful.

[Biogenic amines and their metabolites in brain tumor tissue].

The concentrations of noradrenaline, 5-hydroxytryptamine, dopamine, 5-hydroxyindoleacetic acid and homovanillic acid were determined in the tissue of gliomas, meningiomas and neurinomas of the brain obtained during operations. Significantly higher levels of noradrenaline and 5-hydroxyindoleacetic acid were found in gliomas than in non-malignant tumours.

[Spontaneous resorption of an epidural hematoma. Description of 2 cases].

Two patients with subacute epidural haematomas without shifted ventricular system are described in whom the diagnosis was made by computer tomography 8 and 9 days after trauma. Both patients were treated successfully checking the progress with computer tomography and using agents reducing brain oedema.

[Brain glioma complicated by subdural hematoma].

A case is reported in which chronic subdural haematoma developed in association with a glioma of the left temporal lobe. The stroke-like onset of symptoms one month before surgical intervention, encapsulated liquid subdural haematoma, necrotic cerebral cortex over the tumour and easily bleeding peripheral parts of the tumour suggested a primary haemorrhage into the peripheral part of the tumour followed by penetration of the haematoma into the subdural space.

Possible significance of juvenile oral venous angioma as marker of intracerebral vascular lesion.

This 10-year-old child suffered a hemorrhage into the right parietal lobe, the result of a ruptured arteriovenous angioma. From birth, the boy had a venous angioma of the mucous membrane of the cheek, lower lip, and hypoglossal area on the right side. The coexistence of these two vascular defects is most unusual, and venous angioma in early life may suggest the presence of cerebral angioma.

[Traumatic aneurysm of the cortical branch of the middle cerebral artery].

A 22-year-old patient is described in whom sudden deterioration developed on the 9th day after severe craniocerebral trauma. Left common carotid angiography demonstrated an aneurysm on a cortical branch of the middle cerebral artery and subdural haematoma. During the operation the aneurysm was excluded from the circulation.

[Intracranial hemorrhages in patients with renal polycystic degeneration].

A female patient is described in whom symptoms of cholecystitis developed after operation for intracranial aneurysm. Enlarged polycystic kidney was recognized erroneously as gallbladder and this error led to laparotomy. In another case meningocerebral haemorrhage developed in a hypertensive patient with polycystic kidney degeneration.

[Post-traumatic hematoma of the posterior cranial fossa in a 4-year-old boy with hemophilia A].

A case of a rare post-traumatic complication of haemophilia A is reported. Similarly as other authors an atypical clinical course and growing internal hydrocephalus were observed in the present case. Haemorrhagic diathesis prolonged only the period of healing of the surgical wound.

[Transient involuntary movements after severe cranio-cerebral trauma].

In a patient rhythmic, coarse tremor of the right hand and fingers 5/sec. was observed 5 weeks after severe craniocerebral injury. The tremor occurred at rest and increased during movements but disappeared in sleep.

[Homovanillic (HVA) and 5-hydroxyindoleacetic (5-HIAA) acid concentration in the cerebrospinal fluid of patients with supratentorial tumors and symptoms of intracranial hypertension (preliminary report)].

In 14 patients with supratentorial tumours and symptoms of intracranial hypertension the concentrations of HVA and 5-HIAA were determined in cerebrospinal fluid obtained by lumbar tap. Significantly raised levels of both these metabolites were demonstrated in the cerebrospinal fluid in these patients in relation to controls. The cause of this rise could be excessive production of serotonin or dopamine, increased turnover of these amines or impaired absorption of 5-HIAA and HVA by the choroid plexus of the fourth ventricle.

[Acute traumatic epidural hematoma in a 5-month-old infant].

The authors describe a case of acute traumatic epidural haematoma in an infant aged 5 months after slight head injury Acute anaemia coexisted. In view of the rarity of this complication after craniocerebral trauma in this age group and clinical distinctness of epidural haematomas in children this possibility should be considered in the differential diagnosis of sequelae of head trauma in infants.