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Intracranial Angiography

I. The Diagnosis of Vascular Lesions

Carl F. List and Fred J. Hodges

without incident, and when the patient was last seen, 6 months later, he was symptom free except for right-sided blindness. Case 9. S.M., 558017, male, age 34 . This patient had suffered from repeated attacks of subarachnoid hemorrhage, precipitated by sexual intercourse. Frontal pain, and blurring of vision on the left were the only localizing symptoms. There was a bilateral relative central scotoma for colors. Angiography demonstrated an unusually large saccular aneurysm of the left internal carotid artery just above the anterior clinoid process ( Fig. 7

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Malcolm B. Parhad

rushing into her bedroom. She had various sensations of itching, burning, etc. all over her body. Because of her weakness it was decided to do a unilateral cingulo-tractotomy. Postoperatively she was free from addiction to drugs and most of her complaints ceased. She can sleep without morphine. Sexual Psychopathy . A 65-year-old man had become sexually perverted and bestial. He would not have sexual intercourse with his wife, but would try with cows and other animals. During operation gross organic changes and atrophy were evident in his brain. After the operation

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Husameddin Gokay and Paul C. Buck

. Subsequently the patient was seen at regular intervals. On July 17, 1951, she stated that she seldom had dribbling of urine and she had no difficulty with constipation. She complained of no pain except some aching in the back when she was up too long. Her legs and back were strong and she was doing square-dancing. She also stated that she had normal sensation when the bladder and the rectum were distended and also on sexual intercourse, whereas preoperatively she had no sensation. Examination revealed that the lumbar spine was ankylosed, and the left calf was 1.5 cm. smaller

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Paul Teng and Jack Gordon

excrutiating pain radiating along the lateral side of the right lower limb down to the external malleolus. Resting in bed aggravated the pain and walking eased it. Meanwhile, the patient felt weak at both ankles, the right more than the left. The pain gradually disappeared 1 year later. Nevertheless, the weakness in both legs progressed slowly and she could hardly stand on her toes. She lost the control of her bladder. In association with orgasm during sexual intercourse, she involuntarily emptied her bladder. As time went on, she also was unable to control her anal

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Giulio Gaist and Giancarlo Piazza

bundles arranged in whorls around a small vessel. The stroma appears formed by connective-tissue strands or by short fibrous tracts, partly showing hyaline degeneration ( Fig. 1 ). Fig. 1. Case 1 . Photomicrograph of tumor. Case 2 . No. 64/55. D.M., a 36-year-old male, brother of A.M., was admitted on Feb. 14, 1955. Five months previously he had a first generalized seizure with loss of consciousness during sexual intercourse; a similar episode occurred 1 month later in the same circumstances. Anticonvulsive therapy was prescribed, which he discontinued

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Phanor Perot, William Feindel and Donald Lloyd-Smith

occasional leg pains and some persisting discomfort on neck movements. He was still unable to carry out sexual intercourse satisfactorily due to failure of erection. The main findings on examination included marked weakness of abduction of the right shoulder so that he could lift his arm parallel with the floor but no higher. There was severe residual weakness of the right biceps, triceps, brachioradialis, flexors of the wrist and small muscles of the hand. The left arm and hand were strong. Reflexes were still absent in the right arm and present only in the triceps in

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Jiro Suzuki and Shigeaki Hori

general malaise, diplopia, and disturbance of memory. He had been married 3 months prior to his hospital visit, but soon he could not have satisfactory sexual intercourse. Because of easy fatigability he was often absent from his work, and he developed chills and low degree of fever. Two weeks prior to admission intermittent occipital headache and vomiting developed and slow movement and a staggering gait. Examination On June 24, 1965, the patient was found to have an apathetic facial expression, slow response to questions, paralysis of vertical gaze, left

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Richard C. Schneider, Hazel D. Calhoun and Kenneth A. Kooi

10 years the patient had a few convulsive seizures with a premonitory sensation of floating in air and dizziness. In addition, more recently, he had had a bizarre aura of an extreme feeling of pleasure or exhilaration which he describes as “a sensation similar to sexual intercourse.” There was only the sensory component of this act and no motor activity. On three occasions following the aura he developed rotational movements. The right side of his mouth began to twitch, he felt his head forcibly drawn toward the right side, and then he circled five or six times to

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Robert F. Spetzler, David Winestock, Hans T. Newton and Edwin B. Boldrey

C ases of partial or complete spontaneous thrombosis of intracranial aneurysms in both children and adults have been reported previously. 2–4, 6, 8 In the following case, angiographic evidence of the spontaneous disappearance of an aneurysm is unique because the aneurysm reappeared later. Case Report A 55-year-old white woman was admitted because of severe headache and stiff neck of sudden onset following sexual intercourse. Lumbar puncture verified the presence of blood in the subarachnoid space. The patient had no history of trauma, hypertension

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A. Alan Chambers, Robert Lukin and Nakoto Tsunekawa

the ensuing period, the patient had been totally secluded with virtually no outside contact. For 1 week prior to admission, he fell frequently and manifested more bizarre behavior than usual. A review of his past history was difficult to obtain, but he did admit to having periodic vague headaches, unassociated with nausea, vomiting, convulsions, or visual difficulties. Early in his marriage of 26 years, his wife had had a miscarriage, and shortly thereafter the patient had totally lost interest in sexual intercourse. He shaved only once a week during the course of