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Charles Brenner, Arnold P. Friedman, H. Houston Merritt and D. E. Denny-Brown

occupations (96 skilled or semi-skilled workers). The patients were first examined as soon as they were brought into the hospital, which in most cases was within a few hours after the accident. They then were followed daily during their hospital stay and at intervals of one to two months for periods of six to fifteen months in the out-patient clinic. On each follow-up visit each patient was seen by a neurologist, psychiatrist, psychometrist, electroencephalographer, and social service worker. Roentgenograms, spinal fluid examinations, electroencephalograms and other

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Orville T. Bailey and Franc D. Ingraham

histologically unfavorable tumors may at times result in complete cure. Case 3. Markedly increased intracranial pressure and mild left hemiplegia in child of 5½ years. Exploration—solid dural tumor overlying right motor area and adjacent cerebral cortex. Histology—fibrosarcoma. Well 6 years after operation . F.H. (C.H. ♯197480). At the age of 2½ years the patient was seen in the orthopedic outpatient department because of forefoot adduction. This was thought to be a mild congenital disorder and light casts were made. In a photograph made at the time of this visit, it is of

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Arnold P. Friedman, Charles Brenner and D. Denny-Brown

). The patients were studied as soon as they were brought into the hospital, which in most cases was within a few hours after the accident. They were then followed daily during their hospital stay and after discharge in the out-patient clinic at intervals of one to two months for periods of six to fifteen months. On each follow-up visit each patient was seen by a neurologist, psychiatrist, psychometrist, electroencephalographer, and social service worker. Roentgenograms, spinal fluid examinations, electroencephalograms, and other laboratory procedures were done when

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Paul C. Bucy and Ben W. Lichtenstein

sufficient magnitude to produce very marked neurological symptoms with no evidence of a spina bifida or of any bony anomaly in the cervical region is most unusual. REPORT OF CASE Case #151–279 . The patient A.B.J., an American negress with part Indian blood, aged 40 years, was admitted to the outpatient division of the Department of Neurology and Neurological Surgery on Oct. 26, 1942. She stated that she had been perfectly well until August 1942, when, after a day of unusually hard work, her legs gave way and she slumped to the floor. In a few minutes she arose and

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Robert L. Glass

March 13, and became ambulatory on March 21, then showing a slight limp with the left lower limb. He returned to the hospital for an out-patient examination on April 25, 1946. At that time there was noted slight weakness of the left foot and toes and mild secondary optic atrophy. A second out-patient examination was made on July 25. He denied any specific complaints, but examination showed very slight weakness of the left foot and toes. On August 19 an ophthalmological examination was made. Both optic discs were a little pale. Vision in the right eye was reported as

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Everett H. Dickinson and Bernard H. Pastor

followed in the out-patient department. Comment Although the response was not quite as dramatic in this case as in the preceding one, the improvement in the patient immediately after removal of the subdural collection was quite striking. His rather stormy course we attribute to the concomitant cerebral contusion he must have suffered as evidenced by the grossly bloody spinal fluid. DISCUSSION The mechanism by which subdural collections of fluid form acutely is not clear. The most generally accepted explanation is that they result from cerebrospinal

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Henry A. Shenkin, Eugene B. Spitz, Francis C. Grant and Seymour S. Kety

cortical atrophy was suggested. Phenobarbital and dilantin were undoubtedly effective in controlling her convulsions, but over the course of the years her treatment was inadequate. In November 1946, the patient was admitted to the Hospital of the University of Pennsylvania under the impression, gained from her out-patient record, that she represented a typical case of idiopathic epilepsy. Examination disclosed severe impairment of her memory for recent events and marked emotional instability. Visual field studies revealed an incongruous, incomplete left homonymous

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Eldridge Campbell and Robert D. Whitfield

. Roentgenograms of skull showed only some atrophic changes in the posterior clinoids. 1st Operation . With a clinical diagnosis of unlocalized brain tumor, ventriculography was carried out. Although the fluid was under moderately increased pressure, the ventricular system appeared neither enlarged nor displaced. A right subtemporal decompression was therefore performed because of the papilloedema. Postoperative course was uneventful and she was discharged 16 days after operation, by which time the papilloedema had greatly receded. She was thereafter followed in the Out-Patient

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Robert C. Bassett and Basu K. Bagchi

deficit other than a complete motor aphasia, which gradually improved. He was discharged home on the 14th postoperative day on anticonvulsant therapy. He returned to the out-patient clinic 2 weeks later with his wound well-healed, stating that he had had an occasional mild headache. He complained of having had occasional Jacksonian twitches of the right side of the mouth and transient numbness of the right hand. There was no aphasia. There were no objective neurological findings. He was advised to continue his anti-convulsant therapy. He again returned to the out-patient

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Charles E. Troland and Carroll A. Brown

on Feb. 5,1947 for further therapy. Since discharge he had continued to drink large quantities of water. Otherwise he was living a normal life. Vision was OD 20/70 and OS 8/200. There was a continuing paresis of the right 3rd nerve. Basal metabolic rate was 0. Glucose tolerance test showed a fasting sugar of 96 and after 30 minutes the value was 152. Fluid intake ranged from 1620 to 3300 cc. and output varied from 1300 to 4030 cc. Patient was discharged on Feb. 18, 1947. He has received regular courses of roentgen therapy as an outpatient. He was last seen on Feb