SummaryThe causes of ischaemic myelopathy are described in 25 patients. Nine developed following surgical manipulation or traumatic laceration of the aorta, 1 following intercostal artery ligation, 3 following aortic aneurysm dissection, 2 following myo cardial infarction and/or cardiac arrest, 7 in the absence of any specifically iden tifiable predisposing factors, and 3 in association with decompression sickness. The degree of clinical recovery was greater among those with incomplete spastic (as opposed to complete flaccid) paralysis and among those in whom sensory loss below the level of injury was incomplete. Despite the diversity of mechanisms that may lead to the development of spinal cord ischaemia, structural damage seems in most instances to affect either grey matter or white matter predominantly. Some of the possible reasons for these preferential sites of damage are discussed. Key words: Ischaemic myelopathy; Paraplegia; Aortic diseases; Spinal vascular disease.There are only a few analytical studies in the English language literature of large series of patients with ischaemic myelopathy, although a number of isolated examples of spinal cord vascular lesions have been published. The most recent reviews of this type include those of Garland, et al. (1966), Mannen (1966, Henson andParsons (1967), andSilver andBuxton (1974). The subject has not been treated in any great detail in standard textbooks of neurology (Adams and Victor, 1985) or neuropathology (Adams, et al., 1984;Davis and Robertson, 1985), probably because of the relatively low frequency with which the condition is encountered. Blackwood (1958), for example, was unable to find a single example of arterial softening of the spinal cord among 3737 postmortem examinations conducted over a 50 year period at the National Hospital, Queen Square.On the arterial side, the better recognised causes of ischaemic myelopathy include recent aortic surgery or traumatic injury, aortic aneurysm dissection,

The diagnosis of intrasphenoidal encephalocele may be difficult because of its rarity and its nonspecific signs and symptoms. The authors report a patient with intrasphenoidal encephalocele who was operated on by the transsphenoidal approach with a good result. They also review five reported cases, with discussion of their clinical characteristics and operative indications.