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Axel Olsen and Gilbert Horrax

occasional somewhat obscure cases must always be considered. In a second case in which ventriculography was utilized, evidence of a posterior fossa tumor was definite from air study, but an acoustic neuroma was not expected. The following case is representative: Case 2 . V. S., a 37-year-old white woman, was admitted to the New England Deaconess Hospital on April 5, 1937, with the complaint of headaches for four years and dizziness and double vision for one year. The family and marital history were negative. She had had a toxemia of pregnancy many years before and a

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Harold C. Voris

inoculated with it failed to develop tuberculosis. X-rays of the skull showed marked pressure digitations, separation of the sutures, and erosion of the posterior clinoid processes. She was thought to have a brain tumor but the localization was not clear. Ventriculography demonstrated a marked symmetrical internal hydrocephalus. This was thought to indicate a posterior fossa tumor and a suboccipital craniectomy was carried out. There was no evidence of tumor in the posterior fossa but the arachnoid over the posterior cistern was thickened and opaque. When it was opened

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A Contribution Related to Treatment

Olan R. Hyndman

indicated. If the diagnosis is finally a progressive hydrocephalus due to basilar arachnitis, the posterior horn of a lateral ventricle on one side may be opened through an incision in the brain and the choroid plexus cut away under direct vision and the usual hemostasis. In these cases removal of the ventricular fluid at the time of operation does no harm. In the event of an inoperable posterior fossa tumor and the surgeon feels it advisable and necessary to establish some means of cerebrospinal fluid circulation which might not have been improved by the cerebellar

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Franc D. Ingraham and Orville T. Bailey

Incomplete removal 4th ventricle tumor. Atypical nerve cells with mitotic figures, striated muscle with rhabdomyosarcomatous changes, collagenous tissue. Death 12 months after operation. 5 C.G. 6 months F Hemiplegia, coma, block. Cerebellar None Removal mid-line posterior fossa tumor. Hair, hair follicles, collagenous tissue; inflammatory and foreign body reaction. Living 9 years after operation. ? Slight mental retardation. 6 R.P. 5-10/12 years M Drowsiness, headache, vomiting. Cerebellar None Evacuation of cyst. Stratified

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Wallace B. Hamby

, Case 2 shows that even huge posterior fossa tumors may, at the time of examination, cause no symptoms or signs except trigeminal pain. (4) That trigeminal pain due to expanding lesions in the posterior fossa is ipsilateral. In only 1 previously reported case that has come to my attention has the pain been contralateral to the lesion. Parker's 8 second case presented a picture clinically very similar to Case 1 in the present report. Pain in the right side of the face was so severe that careful examination was not possible until pain had been relieved by

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Arthur Ecker

elevated. Lysholm 17, 19 directed attention to upward displacement of the brain stem only in regard to tumors of the pons. However, the ventriculograms he published show that the posterior portion of the floor of the third ventricle is elevated in all types of posterior fossa tumor. Johnson and List 13 mentioned that unusual, extensive tumors of the pons may displace the brain stem anteriorly, producing corresponding alteration in the appearance of the third ventricle. Ventriculographic differentiation of lesions in the posterior fossa from those in the

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Hemangioblastoma of the Posterior Fossa (Lindau's Disease)

Report of Two Cases with Familial History

F. Keith Bradford

importance when they are present and may well escape a casual ophthalmoscopic examination even if performed by an experienced clinician. In the patient whose history and physical examination are strongly suggestive of a posterior fossa tumor, hemangioblastoma is extremely probable if there is either a familial history of posterior fossa tumor, a familial history of retinal hemangioblastoma or the actual presence of von Hippel's disease. The diagnosis is much more certain if, in the family history, there has been confirmation of a cerebellar cyst, or even better

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Eldridge Campbell and Robert D. Whitfield

discharged Oct. 10, 1941. Her recovery has apparently been complete. Two years later she was doing her housework and considered herself perfectly well. Posterior fossa tumors with calcification demonstrable by roentgenogram are, in our experience very rare. In the next case the lesion was located so high that it was thought to be supratentorial. The patient seemingly came through the operation nicely but died 3 months later of a frontal lobe abscess, the origin of which is not altogether clear. Case 3 . A.H. #A23289. E.J., a 50-year-old white housewife, was admitted to

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Henry G. Schwartz

not surprising that large aneurysmal dilatations in this region are not recognized until operation or autopsy. Of 21 cases of posterior cranial aneurysm in Dandy's 3 series, there were 11 S-shaped, sclerotic dilatations of the basilar artery, with the lateral bend coming to rest against the 5th or 8th nerves, resulting in trigeminal neuralgia or Ménière's syndrome. In Dandy's remaining 10 cases, there were 2 large sacculated aneurysms, which were operated upon for suspected posterior fossa tumor, with fatal outcome. Among 5 cases of small sacculations, Dandy

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W. James Gardner

posterior fossa tumor or a traumatic stricture of the aqueduct of Sylvius. Course . Following this procedure the patient was more alert mentally, but the left eye began again to protrude as the intracranial fluid reaccumulated. This fluid was aspirated by means of a needle introduced through the scalp, but it gradually increased in amount until by the 9th postoperative day it measured 80 cc. When the fluid was aspirated the eyeball receded to approximately its normal position ( Figs. 1 and 2 ). By the 16th postoperative day the amount of fluid recoverable measured