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Louis Bakay and Berten C. Bean

all the necessary information. Craniopharyngiomas Five patients with craniopharyngioma were subjected to pneumography and bilateral carotid angiography. The sella turcica was normal in 4 cases. In 2 of the 5 patients, suprasellar calcification was evident on plain roentgenograms of the skull. At operation all patients showed large, partially solid and partially cystic tumors situated above the sella extending posterior to the sella. Pneumography In 2 patients the chiasmatic and crural cisterns were obliterated completely, a frequent finding in these

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Correspondence To the Editor E. A. Spiegel , M.D. H. T. Wycis , M.D. Temple University School of Medicine and Hospital Philadelphia, Pa. 918 918 Copyright, 1964, by The Harvey Cushing Society. 1964 —We read with great interest the paper by Drs. M. C. Overtoil, III and D. D. Sheffel entitled “Recurrent cystic formation in craniopharyngioma treated with radioactive chromic phosphate. Case report” that appeared in J. Neurosurg. , 1963, 20: 707–710. The treatment of cystic

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Irving S. Cooper and Stanley Stellar

. The following case report demonstrates the use of the freezing cannula for tumors within the sella turcica. Case 2 . J.B., a 16-year-old girl with signs and symptoms of a craniopharyngioma, was treated by right frontal craniotomy. A cyst was evacuated and biopsy was taken. The tumor then was frozen with the cryocannula in five separate places ( Fig. 7 ), dropping the temperature to −100°C. for 3 min. each time. The tumor could be seen shrinking away from the optic chiasm. Recovery was excellent and the patient was discharged on the 8th postoperative day. Visual

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Giampaolo Cantore, Beniamino Guidetti and Michele Virno

, eventually, surgical intervention were carried out. Oral glycerol has been used in 75 patients in the operating room during intracranial surgery . The purpose was to reduce cephalic bulk, to facilitate exposure during operative procedures without sacrificing or removing cortical areas. Glycerol was used chiefly during surgical extraction of tumors of the base of the skull (meningiomas, adenomas, craniopharyngiomas, etc.) and of every expanding intracranial process accompanied by marked cerebral edema (brain abscess, metastatic tumors, etc.). In a few cases, the drug

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Robert H. Wilkins

knowledge regarding the life history of the various lesions. And should they take warning from the experience of others in avoiding overradical attempts to remove large congenital craniopharyngiomas, in refraining from operating on obviously metastatic tumours, and in refusing all secondary operations for recurrences, they could easily attain a case mortality of four or five percent for the whole. Factors influencing mortality percentages . These wholesale statistics, given in the last three tables, will serve, I hope, to give others who engage in like tasks

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Albert N. Martins, George J. Hayes and Ludwig G. Kempe

our attention on the perisellar region. The findings, however, whether from erosion of bone or displacement of vessels, were not distinctive. Pre-operatively, in 4 of our patients, the possibility of the tumor being a craniopharyngioma, chordoma or intracranial invasion by a nasopharyngeal carcinoma was strongly considered. Marked erosion of the body and wings of the sphenoid bone by invasive pituitary adenoma helps to distinguish it from the noninvasive variety, which shows much less destruction and is more apt to enlarge rather than destroy the sella turcica

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Elias E. Manuelidis

After Initial Growth Contamination Glioblastoma 77 28 13 35 1 Astrocytoma 14 1 4 9 Oligodendroglioma 7 1 1 5 Medulloblastoma 8 2 4 1 1 Ependymoma 4 1 3 Neuroblastoma 4 1 3 Ganglioneuroma 2 1 1 Pituitary adenoma 5 3 2 Craniopharyngioma 2 1 1 Neurofibroma 11 1 10 Meningioma 20 1 2 16 1 Hemangioblastoma 1 1 Methylcholanthrene-induced tumors 8 8

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Joseph H. Galicich, Cesare T. Lombroso and Donald D. Matson

work is in progress to make the scans in this area informative. Of 14 verified intradural supratentorial masses 11 were visualized by B-scanning ( Figs. 8 9 10 11 ). Of the masses seen on scans, 7 were gliomas, 3 were craniopharyngiomas and 1 was an abscess. One intracerebral hematoma and 2 gliomas were not visualized although their presence was indicated by a shift of the midline in the region of the mass. No abnormalities could be detected in 3 patients who had extracranial neoplasms with widespread metastases. These patients all had neurological deficits

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Thomas P. Krueger, James McFarland and Ayub K. Ommaya

any intracranial extension of the lesion. Differential Diagnosis Tumors are the most common source of error. Hypophyseal neoplasia, e.g. chromophobe adenoma, probably comes first with nasopharyngeal carcinoma a close second. Other tumors which have to be excluded are craniopharyngioma and meningioma. Chordomas, cholesteatomas, tumors of the sphenoid and ethmoid sinuses and of the nasopharynx and base of skull, such as juvenile angiofibroma, myeloma, and benign polyps, are quite rare. 29 A rare condition is that of pneumosinus dilatans. This is commonly an