The authors reviewed 100 consecutive survivors of aneurysm operations and identified 3 patients who developed postoperative epilepsy. The use of prophylactic phenytoin in the first 67 cases did not seem to influence the patient's risk of developing epilepsy. It is concluded that with present microneurosurgical techniques the risk of postoperative epilepsy is small and unselective use of phenytoin prophylaxis should be reconsidered.

Most surgically treated cases of brain-stem hematomas have been attributed to rupture of cryptic arteriovenous malformations (AVM's); however, very few cases have been histologically proven. Similarly, there are very few reports of surgically treated spontaneous hematomyelia, in which the hemorrhage has been histologically confirmed as being due to a purely intramedullary AVM. The authors report three cases with surgically treated, histologically confirmed AVM's, of which two were in the brain stem and the third was in the spinal cord. In all these cases, abnormal vascular tissue in the wall of the hematoma cavity was recognized at operation and excised.

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The authors report a case of a high-flow posttraumatic carotid-cavernous fistula, with complete steal of the blood flow from the ipsilateral internal carotid artery (ICA). Direct attack on the intracavernous carotid artery was performed using the approach of Parkinson with temporary isolation of the ICA. Complete transection of the artery within the cavernous sinus was encountered. The fistula was occluded by clipping the two ends of the ICA within the sinus. The implications of this previously unreported finding are discussed.