The records of 88 patients with intraparenchymal brain abscess treated during 1946-1971 were reviewed. The incidence of brain abscess did not decline significantly during this period. The overall mortality rate was 36.4%, and the operative mortality rate 29.1%. The most frequent findings were alteration of consciousness, headache, and elevated peripheral white blood cell count; fever, hemiparesis, seizures, neck stiffness, nausea and vomiting, and papilledema were less common. Lumbar puncture was a definite threat to the patient with a brain abscess. Ventriculography appeared slightly superior to angiography in accurately localizing the site of the abscess. There was a close correlation between the preoperative level of consciousness and the operative mortality rate. With the aid of Thorotrast, simple aspiration or drainage was superior to excision; when Thorotrast was not used, excision produced better results. The rate of postoperative seizure disorder was similar regardless of the type of treatment. The operative mortality rate and the postoperative neurological sequelae were less for intracerebellar abscesses than for intracerebral abscesses. KEY WORDSbrain abscess lumbar puncture 9 ventriculography Tborotrast surgical treatment

Experimental Study on the Genesis of Cerebral Vasospasm• The cerebral vasospasm produced by blood, fractions of blood, and blood-borne agents administered intracisternally was studied arteriographically to attain a better understanding of the genesis of vasospasm. The results indicate this phenomenon is multifarious in origin, involving a number of spasmogens. Whole blood, platelets, platelet extracts, some isolated components of platelets, plasma, thrombin, histamine, serotonin and prostaglandins Fi o , E2 and F 2a produced a significant incidence and duration of spasm. Norepinephrine and prostaglandin Ei were inactive. Spasm produced by arachidonic acid and red blood cells was of questionable significance.Compared to whole blood, thrombin usually produced spasm which was more delayed in onset while most other active substances produced a shorter-lived spasm. However, among the pure substances tested, serotonin, prostaglandin E2 and prostaglandin F 2o induced spasm in small doses which most nearly resembled that observed with whole blood.The hypothesis that the course of spasm depends upon synthesis of spasmogens by brain and blood is advanced. Prostaglandin synthesis plays a major role in this concept.

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