The course of 167 patients with a surgically treated metastatic brain neoplasm is reviewed. The most common primary site was lung (37%) followed by breast and skin. Three quarters of the patients had a previous history of malignancy, and one third had a tumor visible on chest roentgenogram. Operative mortality was below 10% after 1950, and was lowest when complete tumor removal was achieved. Corticosteroids had little effect on operative mortality. Median survival after surgery was 6 months, but seven patients survived 5 years or more. Survival was longer if the primary tumor had been adequately treated previously. Surgery is indicated to establish the diagnosis in a patient without a known primary tumor or in one without evidence of dissemination except for a solitary brain tumor. In the latter instance, longterm palliation sometimes rewards aggressive management.

The authors report an unusual case of superior vena cava thrombosis in an infant who subsequently developed communicating hydrocephalus; they also review previously reported cases of dural sinus hypertension, and separate them into two groups. Patients in the first group develop hydrocephalus and those in the second develop a pseudotumor-like syndrome. The former patients tend to have generalized increase in intracranial venous pressure while the latter have a normal pressure in some major intracranial venous structure(s). The absence of venous cushioning of the choroid plexus pulse wave is proposed as the cause of ventricular enlargement in the former group. In addition, patients in the large-ventricle group were younger than patients in the small-ventricle group.

A family with four affected members showed a stereotyped unilateral neurologic deficit. The disorder was characterized in each member by congenital left hemiparesis, with subsequent development of left hemihypoplasia and athetoid posturing of the left hand. Although the proband was initially considered a "cerebral palsy" victim, the autosomal dominant pattern and the stereotyped clinical features in all affected family members suggest a hereditary process. Hereditary factors may be an uncommon cause of static unilateral neurologic motor defects.