The authors describe the case of a 37-year-old patient, who, after a minor craniocerebral trauma suffered in 1970, was admitted to hospital because of progressive headache, unsteady gait and balance disturbances, deglutition disorders and diplopia. Computed tomography (CT) scan showed a large median hyperdense tumour of posterior fossa with the fourth ventricle involvement. Operation under microscope was performed to remove a considerably large cystic tumour, occupying the fourth ventricle and cisterna magna, displacing the cerebellar lobes and pushing the vermis upward. The tumour was waxy and grey, whereas the cystic liquid had the colour and consistency of oily fluid. The capsule was occluded with the CO2 laser. Postoperative course was good.

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Ectopic pinealoma in the region of the optic chiasma.

The authors report the case of a 31-year-old female patient who 10 years earlier had displayed diabetes insipidus and hyperglycemia and for 4 years galactorrhea and amenorrhea. Since one year her visual acuity had gradually declined to blindness. CT-scan revealed the presence of a tumoural formation in the optic chiasma and hypothalamic region. The histological examination of the operative-removed tumour showed that it was a type B pinealoma. The postoperative course was good for 42 hrs after which the patient died suddenly. Necropsy disclosed the presence of a myocardial infarct. The authors distinguish three categories of ectopic pinealoma: 1. tumours of the pineal gland with an aberrant development at the level of the 3rd ventricle, 2. metastatic pinealoma, and 3. ectopic pinealomas with an independent development in patients with normal pineal gland. The case reported below is of the 3rd category which is also the most veridical.

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The prognostic value of ventricular rupture in cerebral hemorrhage.

Analysis of 41 cerebral hemorrhage cases associated or not with intraparenchymatous hematoma and ventricular rupture shows the role played by these associated phenomena in the evaluation and prognosis of these patients. The death rate was 56.25% in simple cerebral hemorrhage, 100% in hemorrhage associated with hematoma, 30.76% in hemorrhage associated with ventricular rupture and 80% in hemorrhage associated with hematoma and ventricular rupture. The authors point out that the mere presence of ventricular rupture is not a really aggravating factor. A particular severity resulting from association of hemorrhage with hematoma seems to be due to the extension of the cerebral lesion produced by the two conditions associated.

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