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Robert R. Smith and Andrew D. Parent

✓ A case of a giant anterior cerebral artery fusiform aneurysm is presented. The lesion was treated by primary excision of the involved segment with an end-to-end anastomosis of the proximal-distal segments of the anterior cerebral artery. It is believed that this technique has not been reported previously for lesions involving major intracranial arteries.

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John P. Kapp and Robert R. Smith

✓ The authors review the literature concerning spontaneous resolution of occlusive lesions involving the carotid artery. They add four cases illustrating three pathological vascular processes that may resolve spontaneously, namely, arterial dissection, atheromatous lesions at the carotid bifurcation, and an arteriopathy involving the intracranial vessels which is poorly understood at this time.

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Robert R. Smith and John J. Upchurch

✓ A modification of the fibrin plate method was developed to measure fibrinolysis in patients with subarachnoid hemorrhage and those receiving antifibrinolytic agents. During the past 2 years, 21 patients with ruptured intracranial aneurysms received epsilon aminocaproic acid. Plasma and cerebrospinal fluid were monitored in 15 of these patients. Dosage factors, duration of action, and complications of therapy are presented. Fibrinolysis in normal plasma and cerebrospinal fluid is also discussed.

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Ben R. Clower, David M. Sullivan and Robert R. Smith

✓ A micro-corrosion technique was used to demonstrate an extensive vasa vasorum network in extracranial vessels but did not reveal this system in intracranial vessels of comparable size in three species of animals. The absence of a vasa vasorum network in cerebral vessels may result in a higher level of susceptibility to periarterial abnormalities, such as cerebral vasospasm secondary to subarachnoid hemorrhage.

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Henry G. Schwartz

Edited by Robert A. Ratcheson

✓ In his final address to the Society of Neurological Surgeons, Henry G. Schwartz, M.D., shared his thoughts on mentoring and recalled specific mentors who contributed to his professional life.

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Robert A. Sanford, Jose Bebin and R. Wayne Smith

✓ The authors present the cases of two young adults with low-grade astrocytomas limited to the aqueductal region of the tectum of the mesencephalon. The characteristic presentation of hydrocephalus without brain-stem signs is described. Careful radiological examination, including computerized axial tomography, failed to reveal any evidence of tumor. The diagnosis was established at postmortem examination. Literature review yielded 12 previous cases of similar presentation.

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Bernard S. Patrick, Robert R. Smith and Terry O. Bailey

✓The authors report a case in which spontaneous extravasation of the contents of a supracellular cyst produced aseptic meningitis.

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Andrew D. Parent, Jose Bebin and Robert R. Smith

✓ Pituitary glands from 500 consecutive autopsies were reviewed and the findings correlated with clinical symptomatology. Occult pituitary adenomas were identified in 42 pituitary glands (8.5%). In only one case was a pituitary lesion clinically questioned, but specific hypophyseal function studies were not performed. These tumors occurred most frequently in the sixth and seventh decade of life, without obvious sex predominance. Of these patients, 48% were obese, 57% were hypertensive, and diabetes mellitus was noted in 34%. Of the 17 cases in which skull x-ray films had been taken, suspicious or abnormal areas were found in 11. The tumor size ranged from 1 to 15 mm, but was greater than 1 cm in only one case. In 34 cases, the tumor was located along the periphery of the gland. Even though the etiological and functional significance of these tumors is unclear, the clinical course appears to be relatively benign.