The authors report on an 11-year-old boy in whom proptosis of the eye caused by a benign intraosseous xanthofibroma of the left orbital wall became clinically apparent at the age of 4 years. Two years later he developed bilateral papilledema, at which time computerized tomography and magnetic resonance studies revealed multiple enhancing intracranial lesions. The largest mass was located in the left middle fossa; other lesions were located at the tentorium cerebelli, in both lateral ventricles, near the superior sagittal sinus, and extracranially near the left jugular vein. The mass in the left middle fossa was resected and diagnosed as juvenile xanthogranuloma (JXG). Thirty months later, the patient again became symptomatic, exhibiting behavioral abnormalities and a decrease in mental powers. At that time, the two remaining lesions in both lateral ventricles had grown enough to cause trapping of the temporal horns and raised intracranial pressure. These lesions were successively resected and histopathologically confirmed to be JXGs. However, resection of the second intraventricular lesion was complicated by postoperative bilateral amaurosis, presumably caused by postdecompression optic neuropathy. According to a review of the literature, fewer than 20 patients with JXG involving the central nervous system have been reported. The patient described in this report is the first in whom multiple intracranial JXGs developed in the absence of cutaneous manifestations. Although JXGs are biologically benign lesions, the treatment of patients with multifocal and/or progressive intracranial manifestations is problematic.

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The authors report on 200 cervical percutaneous cordotomies in 146 patients who were suffering from intractable pain. In order to assess the success rate and the incidence of relapse, the neurological findings immediately post-operatively were compared with the results of a later follow-up. The prospect of success in the treatment of pain appears to depend on the anatomical representation in the spino-thalamic tract of the region of the body which is involved. The incidence of complications and the mortality are compared with the observations of other authors and with the results of open cordotomy.

Tumours in the posterior fossa in children only present minor problems in diagnosis since the introduction of the computerized tomogram, but in postoperative follow-up studies it is rather difficult to distinguish between the various findings in the posterior fossa. This holds true especially for medulloblastomas and ependymomas. Operative changes in the anatomical structures, metal-clips, scar-like changes, post-radiation sclerosis and other findings are reasons why it is almost impossible to diagnose early recurrence of these tumours. In order to obtain more information after operation, CT findings were studied in 36 children with tumours in the posterior fossa. The findings are summarized and discussed.