We performed a randomised prospective double blind trial to study the effect of the calcium antagonist nimodipine on the outcome of head injured patients. The subjects were not obeying commands at the time of entry to the study, within 24 hours of injury. One hundred and seventy-five patients received nimodipine IV, 2 mg per hour for up to 7 days and 176 received placebo. The two groups were well matched for important prognostic features. Six months after injury 93 (53%) of the nimodipine group and 86 (49%) of the control group had a favourable outcome (moderate/good recovery). The relative increase in favourable outcomes (8%) was not significant but is compatible (95% C.I.) with an increase in favourable outcomes in treated patients by 33% or a decrease by 12%. Nimodipine was well tolerated and there were few adverse reactions; means of systolic and diastolic blood pressures and the intracranial pressure did not differ between the groups. It is unlikely that nimodipine has a marked effect on outcome (ie an increase in favourable outcome of greater than 15%) after head injury of this severity but the study does not exclude a modest but clinically useful benefit.

Six patients with aneurysm of the superficial temporal artery are reported from Africa. The presenting symptom was a pulsating swelling in the temporal region, and blunt trauma to the side of the head was the aetiological agent in every case. Treatment by surgical excision is advocated. It is suggested that aneurysms of the superficial temporal artery occur more frequently than reports in the literature suggest.

No abstract

No abstract

A case of Kaposi's sarcoma involving the brain is described, this being the first of its kind in Uganda. The patient was a 40-year-old woman who presented with a 2-year history of skin tumors on the left ankle that proved resistant to chemotherapy. She therefore underwent an above-knee amputation. Six months after amputation, she developed signs of cerebral involvement, and 6 weeks later she died. Necropsy showed large tumor deposits in bone and lungs as well as in the brain. Histologically the cutaneous tumors consisted of the monomorphic variety, whereas the cerebral and other deposits were anaplastic. In the three cases of cerebral Kaposi's sarcoma hitherto reported from other countries, only minute foci of tumor were found in the brain.