The location of corpus callosum injury was investigated using magnetic resonance imaging in 92 patients. The anatomical relationships in the region around the corpus callosum were also evaluated to clarify involvement in the mechanism of corpus callosum injury in 20 normal volunteers. Lesions in the posterior half of the corpus callosum accounted for 80% of corpus callosum injuries. The falx was increasingly elongated toward the posterior portion of the corpus callosum and the corpus callosum was thinnest at the body-splenium junction in the normal volunteers. The mechanism of corpus callosum injury apparently involves the following factors. The posterior half of the falx is closer to the corpus callosum than the anterior half. Therefore, the anterior part of the corpus callosum easily moves with lateral movement of the cerebral hemispheres, and the strain is likely to be concentrated in the posterior half of the corpus callosum, because the falx greatly limits lateral movement of the hemisphere in the posterior region. The corpus callosum is easily distorted at the thinnest part of the body-splenium junction. Therefore, corpus callosum injury predominantly occurs in the posterior half of the corpus callosum.

Cerebral haemodynamics were measured in 22 adult patients with secondary normal pressure hydrocephalus (NPH) before and after glycerol administration to determine which patients might benefit from a shunt procedure. Of these 22 patients, 14 were found to be shunt-responsive (group 1) and 8 were shunt-unresponsive (group 2). Measurement of regional cerebral blood flow (rCBF) was performed by xenon-enhanced computerized tomography (XeCT). Clinical factors such as the Evans' index and the presence or absence of brain atrophy, periventricular lucency (PVL), ventricular reflux, stagnation of cerebrospinal fluid on cisternography, and increased intracranial pressure were not statistically significant predictors of shunt responsiveness. Preoperative rCBF values did not differ between groups 1 and 2. The rCBF value in every cerebral region of group 1 patients increased significantly after shunting except for the basal ganglia. On preoperative rCBF measurement, all rCBF values in group 1 significantly increased after glycerol administration except for the periventricular lucency (PVL). Patients in group 2, however, lacked such an increase in rCBF. We therefore propose that, in patients with secondary NPH, shunt surgery will be likely to be effective in those with a demonstrated rise in rCBF after glycerol administration.

A case of childhood post-traumatic akinetic mutism is presented. The patient showed a hyperphagic condition while recovering from akinetic mutism. He had lesions in the left interlaminal nucleus of the thalamus, right globus pallidus, and right dorsomedial nucleus of the hypothalamus. Laboratory data indicated slightly disturbed hypothalamic functions. In general, akinetic mutism can be seen with bilateral destructive lesions, while hyperphagia may occur after destruction of dorsomedial hypothalamic nucleus, but it is very rare. This is the first reported case of akinetic mutism caused by a unilateral lesion.

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In this study ， a diagnQsis of traulnatic IVH was based on the findings of computeriled tomography （ CT ） performed within 6 hours followillg the head injury ． Excluded from this study were patients whose initial but not follow up CTs showed an IVH ， so as to eliminate a ventricular reflux as an etiology of the hltraventricular blood． Also excluded fronl this study was a patient with an IVII that was due t〔｝ an intraventricular rupture of an intraparenchymal hematoma ， Thus ， a total of 5 patients with a simple traumatic IVH were studied ， 0n admission to hospital it was found that the Glasgow Coma Scale score had varied ， but although all 5 patients were unconsciousness ， 4patients recovered within 48 hours of their injury ， In contrast ， the outcome was 】 ess favorable for 50ther patients wh 〔 〕 had a traumatic IVH associated with a primary brainstem injury and ／ or diffuse brain swelling ， and all these ！ atter patients ultimately died or lapsed illto a persistent vegetative state ． Further， of 7 patients with a traumatic IVII and a focal brain injury ， 6 （ 86％ ）had a favorable outcome ． It thus has been concluded that tbe outconle of a traumatic lVH depends nlore upon the severity of the brain injury rather thall on the presellce or absence 〔 ｝ f intraventricular hemorrhage ． （