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Arthur Ward and R. Glen Spurling

present: paralysis of the 6th nerve, paresis of the 7th nerve, trigeminal hypesthesia, occasional visual field defects and occasional signs of thalamic or pyramidal tract involvement in the larger, invasive malignant tumors. The symptomatology and pathophysiology of these lesions have been well summarized by Fulton and Bailey. 4 The diagnosis in each case was substantiated by the characteristic ventriculographic findings. In all instances of radiosensitive glioma, the neoplasm occupied the posterior half of the third ventricle as judged by ventriculography. One of the

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James C. Fox Jr.

described in detail. 3. The prolonged loss of visual acuity and the marked astereognosis indicate that the visual and sensory cortex were particularly vulnerable to the injurious anoxic effects. 4. Final complete recovery is evidence of reversibility of the brain changes resulting from the prolonged hypoxia. 5. Both clinical and experimental data support the concept of a gradient of susceptibility as the neuraxis is descended from cerebral cortex to spinal cord. 6. The probable pathophysiology associated with interruption of cerebral blood

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Arthur Ward Jr.

pathophysiology of cerebral trauma and therapy must of necessity be somewhat empirical at present. It is hoped that the search for specific therapy will yield some of the needed data. SUMMARY 1. It is known that following cerebral trauma, both in experimental animal and in man, free acetylcholine is found in the CSF in rather large amounts, whereas normally none is present. In the experimental animal both the EGG patterns and the stuporous condition resulting from cerebral trauma may be abolished by appropriate doses of atropine sulfate. 2. On the basis of

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Phantom Limb in Paraplegic Patients

Report of Two Cases and an Analysis of Its Mechanism

Albert W. Cook and William H. Druckemiller

in over 90 per cent of all patients who had had an amputation. Pain is not a constant feature of this syndrome, as indicated in the report of Browder and Gallagher, 3 who found it to be present in approximately 30 per cent of their patients. Furthermore, only 20 per cent of this group of patients, or 6 per cent of their total series, experienced pain of an enduring character. In spite of the common occurrence of the phantom syndrome little attention had been directed to its pathophysiology until the introduction of various surgical procedures designed to relieve

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Joseph C. Yaskin

change in neurological thinking, at least among the younger neurologists who survive these various invasions into neurology. There is a tendency on their part to return to the earlier concepts that neurology is a part of internal medicine, clinical and experimental, and they devote their energies along these directions, finding a place for themselves, at least in the larger medical centers of the world. They attempt to investigate conditions that are not as yet understood from the standpoint of etiology, pathogenesis or pathophysiology and are not amenable to various

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S. Obrador

neurosurgeon, with a knowledge of the pathophysiology of the disturbance, must be radical in his efforts to remove the affected regions. In reviewing our material of the last 5 years it was found that in a series of 755 major intracranial operations, there were 130 patients (17 per cent) with epilepsy. These cases may be divided into the following groups. I. Expansive intracranial lesions (90 cases) II. Focal cerebral lesions A. Localized cerebral scars (11 cases) B. Cerebral atrophies (19 cases) III. Psychomotor and other

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Eldon L. Foltz, Fritz L. Jenkner and Arthur A. Ward Jr.

S ince the incidence of closed head injury seems to be assuming increasing proportions in modern high-speed life, a better understanding of the phenomenon of cerebral concussion is needed. Unfortunately, relatively little basic information is yet available regarding the detailed pathophysiology of cerebral concussion. 2 The mechanics of brain trauma have been investigated rather extensively and Denny-Brown and Russell 4 have pointed out that both compression and acceleration concussion can occur although the latter is responsible for the majority of cases

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William E. Hunt, John N. Meagher and James E. Barnes

T he management of intracranial aneurysm has changed rapidly in the past few years. The trend has been toward direct intracranial attack with occlusion of the aneurysmal sac at its base. Some surgeons still favor carotid ligation or “trapping” procedures in which parent vessels are sacrificed. Others still advocate no surgical treatment at all, on the grounds that the hazards of treatment exceed those of the lesion. We have evolved certain principles of management based upon current concepts of the pathophysiology of subarachnoid hemorrhage. This paper

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Russell Meyers

destructive lesions in those patients exhibiting postoperative deficits in libido and potency. 15 The neurosurgical procedures unwittingly amounted to reverse counterparts of the studies on the monkey and the data reported constitute the first presumptive evidence pertinent to the physiology and pathophysiology of these aspects of the reproductive function in the human. In addition, there is strong indication that, wherever the central neural mechanisms may be that prompt the pituitary gland to release ACTH and gonadotrophins, they apparently are not located close to the

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James R. Atkinson and Eldon L. Foltz

E valuation of the pathophysiology involved in the alteration of cerebrospinal fluid dynamics resulting in hydrocephalus has vexed observers for many years. More adequate means of investigation have been needed by the neurosurgeon, in particular, who must decide the feasibility of surgical intervention in each case encountered. Recognition of the effects of the disease presents no unusual problems. Marked ventricular dilatation and, in the infant, an enlarging head are common clinical entities. The problem arises in determining the activity of the disease. If