Two hundred‐twelve consecutive patients with small cell carcinoma of the lung were included in an evaluation of clinical and diagnostic neurologic findings of intracranial metastases. A correlation of premortem findings to postmortem examination of the brain was obtained in 87 of the patients. Clinical intracranial metastases were diagnosed in 21.2% on the basis of symptoms and signs. At autopsy 44 of the 87 patients (50%) had metastases. Lesions located to the posterior cranial fossa were demonstrated in 53% of the positive autopsies. A correlation of 96% existed between significant premortem clinical findings and positive autopsy, while 33% had clinically “silent” metastases at autopsy. A neurooncologic examination was performed in 49 patients at the time of presentation of neurologic symptoms. Twenty‐eight patients were considered to have intracranial metastases. Gait disturbances were the presenting signs in more than 50% of the patients. Brain metastases were demonstrated at autopsy in 14 of 15 patients considered to have intracranial metastases by the neuro‐oncologist, and clinically “silent” metastases were observed in one out of 10 patients. Radionucleide brain scan was negative in seven of 13 patients in spite of “positive” neuro‐oncological examination and a subsequent positive autopsy. Cerebrospinal fluid examination was of no value in the diagnosis of brain metastases. It is concluded that a careful clinical examination by a neuro‐oncologist is of great value in early detection of brain metastases, especially in diagnosing metastases to the posterior cranial fossa.

1976) Neuropathology and Applied Neurobiology 2, 349-364 I n ritro characteristics of a fourth ventricle ependymoma maintained in organ culture systems : light and electron microscopy observationsExplants of a well-differentiated fourth ventricle ependymoma were grown on collagen-coated coverslips and in organ culture systems using gelatin sponge foam matrices and Millipore filter platforms. Viable explants were maintained on Millipore filter platforms up to 44 days and on sponge foam matrices up to 86 days. The structure of ependymal rosettes was well maintained throughout the period of study. By electron microscopy, additional features of differentiation were seen after 3 weeks, consisting of an increase in size and complexity of microrosettes, to which large numbers of cellular apical profiles contributed. Cilia with variable internal configurations were present. After 4 weeks there was frequent ependymal differentiation along the surface of the explants at their interface with the supporting matrix. Increased gliofibrillogenesis and glycogen rosettes were also evident after 3 weeks in culture. The explants were intensely positive when tested by immunofluorescence for the antigen of the glial fibrillary acidic protein. After 3 weeks in uitro, dense bands of basement membrane material forming complex intercellular finger-like projections became prominent. 349

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