Drake and colleagues in several hundred patients with Grade I aneurysm. 1 ' 6 In the present study, 4 new postoperative deficits appeared after rupture with forced vascular clipping, vasospasm, or edema. These postoperative deficits might have been exacerbated by hypotension, which was sometimes protracted.In this study, EEG did not identify intraoperative local ischemia in 3 patients with immediate postoperative focal deficits. Several reasons may explain the failure of EEG to predict these deficits. Most importantly, infarction caused by hypotension was not identified in these patients, and thus we lacked a clear-cut hypotensive stress for detection by EEG surveillance. Moreover, standard EEG electrodes could be placed only in the area over the unoperated scalp and, therefore, the area of potential maximum vulnerability was not monitored.EEG with scalp electrodes near but outside the surgical site does not seem helpful for monitoring cerebral function in the region of aneurysm surgery. Preliminary studies in our operating room suggest that electrocorticography over the operative area will be more revealing.

GRANULOMATOUS AUGUTIS/Burger et al. 29detrimental (61.1% to 62.5%) than beneficial (38.9% or 37.5%). 13 Correlations between the type of response (beneficial or detrimental) and various factors have been searched for in order to predict the type of response in other patients. Only angiographical findings gave a positive correlation. As shown in table 2, the probability for the occurrence of a decreased perfusion is higher when the arteriogram shows an intracranial thrombosis. It is indeed conceivable that a cerebral region deprived of its main arterial supply but with all its patent arteries already maximally dilated can by no means benefit by the action of a vasodilator. tral nervous system, the disease nevertheless retains sufficient individuality to warrant status as an entity, and should be considered in the differential diagnosis in adults with lesions which produce focal neurological deficits and signs of increased intracranial pressure. The definitive answer regarding an infectious etiology will come only from detailed culture studies of the affected vessels.

No abstract

Two adults presented with frontal lobe masses. As visualized by computerized tomography, both lesions were large cysts with contrast-enhancing mural nodules and enhancing circumferential rims. En bloc resections of the mural nodules and cyst walls were performed. Pathological evaluation of each nodule disclosed a meningioma, and neoplastic cells were found in the distant cyst walls. Although the walls of large cysts associated with some meningiomas have been composed of reactive glia or collagen, the neoplastic character of the cysts in the present cases underscores the need for resection and careful pathological evaluation of the large cysts associated with meningiomas.