Neuropsychologic follow-up studies of a 5 1/2-year-old boy who had left hemispherectomy for seizures showed that he had developed superior language and intellectual abilities. These findings contrast with recent reports indicating that the plasticity of the nervous system may have been overrated and contradict reports of restricted development of language functions after left and of nonlanguage functions after right hemispherectomy for perinatal lateralized brain lesions. Following removal of the left hemisphere, including "the classical language zones," the right hemisphere and other intact residual structures may provide the necessary substrata for the development of above normal adult language and intellectual capacities.

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Ventricular sizes on computerized tomographic (CT) scans were compared in seven patients with Huntington disease, 20 patients with cerebral atrophy, and 20 normal controls. The bicaudate index--the ratio of the width of both lateral ventricles at the level of the heads of the caudate nuclei to the distance between the outer tables of the skull at the same level--significantly discriminated among the three groups. The bicaudate indices were: Huntington disease 0.209 +/- 0.007, cerebral atrophy 0.121 +/- 0.006, and controls 0.092 +/- 0.003.

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The authors report a series of 80 cases of traumatic subdural hygroma and discuss the clinical and radiological features, management, surgical results, and pathogenesis. Changes in mental status without focal signs of brain damage were noted in over 50% of the cases. A clinical course marked by stabilization without complete recovery of neurological function was found in over 40% of the cases of "simple hygroma." The lumbar cerebrospinal fluid often showed hemorrhage and elevation of the protein content. Skull fractures were found in 39% of the cases, and subdural hygromas were associated with cerebral atrophy, cortical contusions, subdural hematomas, and overlying epidural hematomas. The characteristic angiographic and computed tomographic scan findings are discussed, as are surgical pathology and outcome. Several theories of pathogenesis are presented. The authors advocate simple burr hole drainage as the treatment of choice. Significant reaccumulation may occur occasionally.