Numerous attempts have been made to clarify and to quantitate characteristic find ings of EEG by means of a computerized analysis.
The representative methods among them are: frequency analysis with band-pass filter, correlation analysis and Fourier transform of autocorrelation function, spectral analysis with fast Fourier transform, spectral analysis with autoregression, etc. Observation of the evoked potentials by averaging summation technique is also widely used.
Although these methods are useful for some specific purposes to some extent because they can demonstrate and quantitate characteristic findings of EEG in part, they are not so useful for a whole diagnosis of clinical EEG on a routine basis which requires analysis of its various elements.
The authors have developed a method in which the process of reading an EEG by specialists is simulated faithfully using a computerized system (the computerized wave form recognition method).
The computerized wave form recognition method for basic activity, which has been completed so far, is basically more accurate than the reading by human eyes, because this computerized method measures each wave of an EEG and calculates it for a specific purpose.
The subjects the author described in this paper are: the introduction of this method, normal range of basic activity in adults, laterality, sex differences, and changes from adolescence to adulthood, etc.
These results will be useful as basic data to apply this method effectively for diagnosing EEG in a routine clinical work.

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This report dealt with the distribution of the DNA content in cells obtained from 15 cases of glioblastoma and 34 cases of meningioma. Analysis was carried out by flow cytometry (FCM) using suspension of single separated cells stained with propidium iodide as DNA intercalating fluorochrome. Cell kinetics and proliferative activities in the different parts of a case with glioma and a case with meningioma were studied by FCM and for morphological changes (LM).
From the distribution of their DNA content the 14 specimens of glioblastoma were classified into 3 types. Egde of the gliobastoma manifested 2 peaks in the DNA histograms which represented the highest increase in the proportion of G₂+M phase and S phase. Periphery of the glioblastoma revealed the infiltrative tumor cells by FCM and LM. However, the DNA histogram of the meningioma showed the same patterns in the different regions.
FCM represented the clinical diagnostic value of the malignancy of the brain tumor and will be applied to study the proliferative activities of tumor cells.

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The clinical features of 7 cases of germinoma (so-called two cell pattern pinealoma) were reviewed;4 histologically verified and 3 histologically non-verified. Among these 7 cases, we experienced 3 disseminated ones, but only in the spinal region. A course of radiotherapy for these 3 cases was given and we applied routinely irradiation for the whole brain, but didn't apply whole cerebrospinal axis irradiation. The general prognosis of all cases was good.
Among our cases, case 6 of germinoma in the right basal ganglia and it's surrounding tissue had precocious puberty with abnormal levels of HCG. In addition to excessively high concentrations of HCG in the urine, serum and cerebrospinal fluid (CSF), elevated plasma LH and decreased plasma FSH were revealed. Craniotomy was performed and this case was diagnosed as germinoma histologically. However, syncytiotrophoblasts generally observed in the choriocarcinoma were seen in it's tissue. By means of peroxidaselabeled antibody method, the authors proved HCG in syncytial cells of the tumor's tissue.
It is well known that germinomas are extremely radiosensitive and some of them rapidly disappear by follow-up CT scanning after irradiation with as little as 2000 rads. The authors would like to emphasize;1) Histological classification has been well established by introduction of the germ cell tumors including germinomas and choriocarcinoma. 2) preoperative diagnosis has been made more accurate by tumor-marker such as alphafetoprotein and HCG. 3) Operative procedures have been refined by microsurgical techniques.

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In order to evaluate the effectiveness of radiation therapy (Lineac 10 MV X-ray irradiation) for primary brain tumor, we performed CT scan before and after radiation therapy in 21 patients.
We observed reduction of tumor size in 62% of cases (13/21), no change of tumor size in 29% of cases (6/21) and increase in tumor size in 9% of cases (2/21) after irradiation.
We consider that CT scanning is highly useful technique for evaluation of effectiveness of radiation therapy for brain tumors.

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Nitrosoureas are widely used for chemotherapy of malignant brain tumors. Fourteen cases of malignant brain tumor received intravenous injection of 100-150mg/body ACNU, and the concentration of ACNU in blood and cerebrospinal fluid was measured.
Results obtained were as follows: 1) ACNU concentration in cerebrospinal fluid and its ratio to that of serum showed various value of 0-0.76 μg/ml (0-63%) after 30min.
2) Concentration of ACNU in spinal CSF and in ventricular CSF was different, and CSF/serum ratio was 19.9% and 42% in ventricular CSF.
3) There was no statistical relation between ACNU CSF/serum ratio and the post-operative time. Transition of ACNU into cerebrospinal fluid during the intra-radiation therapy disclosed high value of CSF/serum ratio.
4) There was no relation between ACNU CSF/serum ratio and the CT scan findings.
5) For the purpose of remission, ACNU should be intravenously injected during the period of the radiation therapy.

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A case of astrocytoma with severe leucocytopenia and thrombocytopenia after ACNU administration was reported.
A 50-years-old woman was first seen at the Department of Neurological Surgery, Sagamihara National Hospital on June 27, 1980, with a complaint of convulsive seizure. Neurological examination showed dyscalculia and hyperactive DTR on the right side. Routine blood studies on admission were normal. The leucocyte count and thrombocyte count were 4, 700/mm³ and 204, 000/mm³ respectively. Both CT scan and carotid angiogram showed a mass lesion in the left f ronto-temporal region.
On July 9, 1980, partial removal of the lesion was performed. Histological diagnosis of the excised specimens was grade II astrocytoma. On July 22, 1980, radiation therapy was initiated with combined use of ACNU 2mg/kg (total 100mg) i. v.. ACNU in a dose of 100mg was administered repeatedly after 14 days. On the 16th day after initial administration of ACNU, radiation therapy was interrupted because of leucocytopenia (leucocyte count;3, 200/mm³). Total dose of irradiation was 1, 940 rad. The leucocyte count and the platelet count dropped from 4, 700/mm³ to 500/mm³ on the 38th day and from 204, 000/mm³ to 15, 000/mm³ on the 43rd day, respectively, after initial administration of ACNU. Leucocyte and platelet recovered within 2 weeks after reaching their nadir. However, multiple subcutaneous abscess and intramuscular abscess of the both upper limbs developed.
Recent neurological examination and CT scan on January, 1982, showed no evidence of recurrence of the lesion. However, her upper limbs developed severe contraction because of intramuscular absess and was severely incapacitated.
The usual dose regimens of ACNU in phase II study were 2 to 4mg/kg i. v. every 6 to 8 weeks or 2mg/kg i. v. once a week for 2 to 4 successive weeks. The mean time to appearance of nadir platelet and nadir leucocyte was reported to be about 4 to 5 and 5 to 6 weeks, respectively, after ACNU administration. And it was also reported that the mean nadir of leucocyte was 1 to 2 weeks behind the mean nadir of thrombocyte.
From our experience, we emphasized that the repeated administration of ACNU should be made at about 6 weeks intervals in terms of hematological side effects. One of the different features of the hematological side effects in the present case, in comparison with the reported cases, was the nadir of leucocyte followed by the nadir of thrombocyte.

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The efficacy of surgical decompression for supratentorial gliomas was studied retrospectively by CT and by postoperative course. We had 5 patients with glioblastomas 5 initial surgery and one second surgery for regrowth and 3 patients with astrocytomas.
Internal decompression was performed before irradiation in all patients except one who was given preoperative irradiation and deteriorated suddenly, and emergency operation of internal and external decompression was performed. Decompression was enough in 5 patients and they were discharged on foot after post-operative irradiation. Decompression was not enough in 4 patients. There were one postoperative death, 3 patients with postoperative CSF leakage through wound and menin-gitis. These patients could not have better living postoperatively. In conclusion, surgical decompression must be extensive enough to control intracranial pressure in the treatment of gliomas. Incomplete decompression may result in post-operative death or complication of CSF leakage and meningitis that might prevent the patient from having postoperative good life. This surgical decompression should precede irradiation because the patient of glioma with increased intracranial pressure may deteriorate rapidly during preoperative irradiation.

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The increased frequency of detection and early diagnosis of metastatic brain tumors have been made possible since the recent introduction of the CT scan. The method of treatment, however, remains controversial. Patients with metastatic brain tumors are often rather elderly and suffer from increased intracranial pressure, with the primary tumor often untreated or recurrent;thus treatment presents many difficult problems.
Thirty-three patients with metastatic brain tumors treated surgically in our clinic were reviewed. These patients were all operated in order to alleviate their symptoms. This study also included multiple metastatic cases, for whom surgery was often considered to be contraindicated. Postoperative median survival period was 23.5 weeks;26/33 enjoyed useful lives for more than 8 weeks after surgery.
We believe that in the treatment of metastatic brain tumor, surgery is the treatment of choice when the patient is suffering from acutely increased intracranial pressure, even in cases of multiple metastasis.

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Two cases of intracranial tumors developed in the first year of life were studied. Especially, one case was a newborn baby.
Case 1. A three-month-old boy was admitted because of large head and generalized convulsion. Panangiography revealed large mass lesion in the right temporal lobe. The tumor was subtotally resected. Histologically, the tumor was diagnosed as gemistocytic astrocytoma. The patient received whole brain irradiation of 6000 rads. He has been alive for 7 years.
Case 2. A seven-month-old boy was admitted because of left hemimotor weakness. Right angiography showed suprasellar mass lesion. Operation was performed and the suprasellar tumor was subtotally resected. Histology revealed pilocytic astrocytoma. He was given whole brain irradiation of (BAR therapy. BudR+methotrexate) 5000 rads. He was readmitted at the age of eight because of lethargy. The enhanced CT scan revealed high density area in the suprasellar area. Bilateral carotid angiography showed narrowing of each intracranial internal carotid artery and vascular net at Willis circle. Biopsy of suprasellar area was performed, no tumor cells were found. These findings suggested that excessive irradiation produced the radiation necrosis and carotid occlusion.
This patient has been alive for 10 years with having some difficulties in daily life.

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Recently the diagnosis for intracranial lesions is sometimes confirmed only by CT scan. Some intracranial lesions such as hematomas, tumors or foreign bodies are relatively small and relatively deeply situated in the brain. In these cases they can not be approached from the surface without being damaged excessively to the surrounding normal brain tissue frequently. Moreover, the angle of the CT scanning is not always the same. Several literatures concerning the technique for craniotomy localization of the intracranial lesion using CT has been published since 1975. Our simple and cheap technique modifying Hink's method is actually useful. We can mark the location on the scalp more easily and correctly.

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The cerebellar atrophy in epileptic patient is well known phenomenon. Some authors (Dam, 1970 et al.) attribute this atrophy to the anoxia during seizures, others (Kokenje, 1965 et al.) to the anti-epileptic drug intoxication.
We have quantitatively measured the size of cerebellum on CT films of epileptic patients and analyzed the cerebellar atrophy in relation to the seizure frequency and to the diphenylhydantoin (DPH) medication.
Methods: CT films of 50 idiopathic epileptic patients taken during Feb. 1972-Dec. 1980 were analyzed. (generalized tonic-clonic seizure 37, psycho-motor 5, abscence 4 and others 4). The average periods from the initial seizure and DPH medication to this CT evaluation were 8.1 and 5.8 years respectively. Films of 20 minor head injury cases of the similar age group were used as control.
Thirty-five, 3mm slice, original horizontal films were reconstructed into 1mm slice, sagittal films and the square measures of cerebellum and cerebrum were calculated by planimeter. The ratio of cerebellum to suboccipital space and that of cerebrum to calvalium were used as parameter for the intensiyy of the atrophiet.
Resutis: In control group, the average ratio of cerebellum to suboccipital space is 80.0±2.2% with the decreasing ratio in older cases. In epileptics the ratio comes down to 71.8±7.6%, showing the definite atrophies in epileptics.
There is high correlation coefficiency (r=0.70) between cerebral and cerebellar atrophies in normals. However, in eptileptics there exists very low interrelationship between the two atrophies (0.05).
The accumulated number of seizures have high correlation with the cerebral atrophy (r=0.61), but have low one (r=0.19) with the cerebellar atrophy in epileptics.
The most strongly related factor to the cerebellar atrophy is blood DPH level of the patients (r=0.50). Cases with DPH level of more than 10ug/ml have cerebellar percentage of 64% on average, besides, cases with level of less than 10ug/ml have 74%.
Conclusion: Though the genesis of the cerebellar atrophy in epileptics would be multioriginal, our analysis revealed DPH level has stronger influence on the cerebellar atrophy than the seizure frequency. It is suggested that we have better to start with other drugs than DPH for the control of epilepsy. Further studies with other drugs will be followed.

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In this study we examined the surgical indications for patients with putaminal hemorrhage. We studied the correlations between neurosurgical findings at the time of admission, CT findings within 24 hours after onset and mortality rate in 23 non-surgical cases and 37 surgical cases with putaminal hemorrhage. We found that surgical treatment was unnecessary in cases with alert consciousness to somnolence and/or cases in which the image of hematoma on CT was localized to the outside of the internal capsula or extended only to the anterior limb.

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We made the evaluation based on six inhibiting factors for 80 cases of those hospitalized patients (male: 48 female: 32, average age: 65) for three years since November 1978, who had been completely bedridden due to their severe cerebrovascular disorder before we began the rehabilitation.
Severe patients had concurrently several problems such as dyskinesia, lack or loss of the will to recover, communication disorder and/or bladder-rectum disorder, which were major factors in the treatment of our rehabilitation.
The results of our rehabilitation was as follows: remarkable improvement was observed 14% of cases who were able to walk upright, and moderately improved in 22%, a total of 36%. No improvement was seen in 39% as unchanged group, and mildly improved in 25%.
These results suggested that over 80% of patients were able to be transferred and treated in the rehabilitation ward out of bed and that the average bed-leaving time was 16 days.

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The purpose of this study was to discuss the inhibitory factors on gait against exercise in hemiplegic patients with cerebral infarctions. The following factors were evaluated in sixty-two patients: sex, age, side of hemiplegia, CT-scan findings with gait evaluation.
There were thirty-two men, and thirty women and average age was 65.3 years old. These patients were divided into two groups: the practical gait group and non-practical gait group. The former group could walk faster than 0.5 meters a second and the latter group slower than this speed including patients unable to walk.
The several limiting factors obtained from this investigation about walking were as follows.
1) Cortical atrophy seen in CT-scan findings.
2) Ventricular dilatation seen in CT-scan findings.
3) Low-density areas including cortex, subcortex and paralateral ventricular body and/or the region of basal ganglia, internal capsula and thalamus on CT-scan findings in patients over sixty-five years old.
4) Low-density area in para-lateral ventricular body in right cerebral hemisphere on CT-scan findings in patients over sixty-five years old.
These results suggested that the exercise effect on gait was influenced by age, mental dysfunction and local dysfunctions of the brain.

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Trigeminal neurinoma is relatively a rare tumor. Incidence of this tumor is only 0.2% of all intracranial tumors and 2.8% of all neurinomas. Most popular neurinoma is acoustic tumor and 2nd is trigeminal one. Since initial description by Smith in 1836, as little as 300 cases have been reported, of which 9 reports and 38 cases have been reported in Japan from 1967 till 1981. We would like to present our two cases.
Case 1: A 40 years-old man admitted to our hospital on May 23rd '80, complainning of dull headache since end of Dec. '79. His past history revealed chronic hepatitis, HB positive. On admission there were slightly right facial pain and horizontal nystagmus at lateral gaze. CT scan showed slight destruction of petrous apex with low density area at right posterior fossa, contrast enhancement revealed a dumb-bell shape high density area in both middle and posterior fossa with low density area (associated cyst was suspected). Spinal tap was done, initial pressure and cell count were within normal range, but C. S. F. protein increased to 250mg/dl. Vertebral angiography showed deviation of basilar artery and rt. P. C. A. On June 12th we operated using C. U. S. A., easy to remove tumor and less bleeding during the operation. After operation his liver function deteriorated than preoperative state. On Oct. 31th he was discharged with slightly right facial hypesthesia but no other neurological deficit till now, Feb, '82.
Case 2: A 17 years-old student was referred to our hospital because of choked disc, disturbances of ocular movement, left facial numbness, diminished corneal reflex and exophthalmos on July 24th '80. He first noticed headache one and a half year prior to admission. Craniogram showed bony erosion of foramen ovale, foramen rotundum and pyramidal apex. CT scan showed large round mixed density area, and rim and cysten wall were enhanced by contrast medium;C. A. G. showed elevation of M. C. A;R. I. scan showed huge round hot area. On July 31th tumor was removed, after operation visual acuity was improved but jaw deviation developed as he opened his mouth. Now he is healthy and goes to school (Feb. '82). Trigeminal neurinoma is usally benign slow growing tumor, so we must diagnose and operate on in its earlg stage. For this purpose CT scan especially enhancement study is very helpfull to diagnose, because all of the tumors appeared circumscribed and marked high density areas after infusion of contrast medium. Neurological examination is, of course, important still now.
Cavitation Ultrasound Surgical Aspirator (=C. U. S. A.) is also usefull to remove such kind of intracranial tumors.

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A 47-year-old housewife was admitted with the main complain of right-sided stiffness. The symptom began 4 month prior to admission and was progressive in course. She was slow in motion and forgetful, had masked face and right-sided cogwheel rigidity. There was no tremor.
Though she showed some improvement on antiparkinsonian therapy for two months, when some signs of elevated intracranial pressure (headache, nausea) appeared. CT examination revealed a large parasagittal meningioma in the left middle third of superior sagittal sinus and there was a slight midline shift. After operation, the patient showed remarkable improvement within a few weeks. This case might suggest that hemiparkinsonian patients should be examined by CT scanning.

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