Previous reports have shown that dibutyryl 3', 5'adenosine monophosphate (DBc-AMP) suppresses growth of actively dividing tumor cells, accelerates normalization of cellular metabolism and elevates the intracellular level of cyclic AMP.
In an effort to study this mechanism further and define its significance, studies were performed on pregnant rats with ethylnitrosourea (ENU) induced gliomas and human subjects with malignant gliomas.
RNA and DNA were detected in remarkably high concentrations in the tumor tissue with a significant reduction after treatment with DBc-AMP. The reduction was more pronounced with RNA.
Free amino acids were noted in relatively low concentrations in tumor tissue. However, treatment with DBc-AMP resulted in a significant elevation of their value. The levels of glutamic acid, aspartic acid and GABA increased to levels corresponding to the composition of free amino acids in normal brain tissues.
Lysosomal enzyme activity in tumor tissue was 10 times greater than that in normal brain tissue. This activity dropped significantly after administration of DBc-AMP. In rats with ENU induced glioma, the uptake of radiocative [H³] DBc-AMP by tumor tissue occurred in a volume 2-3 times that of normal tissue. However, the ratio of [H³] cyclic AMP/cyclic AMP was less than that in normal tissue, implying that an enhanced synthesis of endogenous cyclic AMP occurs after administration of DBc-AMP.

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The whole brains of pubescent and fully adult rhesus monkeys were subjected to 6, 000 rads of fractionated supervoltage X-irradiation, and the difference of these two age groups in clinical and neuropathological changes after the irradiation was studied. The pubescent monkey was more vulnerable to irradiation than the fully adult monkey, and showed more clinical signs and more focal lesions of delayed brain damage from radiation.

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Bilateral lesions made in the midbrain reticular formation of the rat produced behavioral akinesia. These animals neither ate nor drank. EEGs of these animals usually showed high voltage slow waves at rest. Slight EEG arousal response was demonstrated by clapping, touching and pinching only in rats with moderate impairment.
Concerning the rates of local cerebral glucose utilization (LCGU) measured by means of the autoradiographic [¹⁴C] deoxyglucose method, 13 structures exhibited significant reductions in 28 gray structures examined when compared with sham operated rats. Lesions in the midbrain reticular formation resulted in reduction of LCGU in the neocortex, ventral nucleus of the thalamus, subthalamic nucleus, and medial and lateral geniculated bodies, mamillary body, septal nucleus and caudateputamen. Structures which did not show any significant change in LCGU were those related to the paleo and archi-cortices. These findings suggest the existence of two types of ascending activating systems.
Administration of 30 mg/kg of pentobarbital reduced LCGU diffusely throughout the brain. When thyrotropin releasing hormone (TRH) was administered to rats with lesions in the midbrain reticular formation, reversal of the reduction of LCGU was observed in the dorsomedial nucleus of the thalamus and the mamillary body. Reversal of LCGU in the dorsomedial nucleus of thalamus was especially significant and its level exceeded the level of the sham control value. This suggests TRH might exert its function through the dorsomedial nucleus of the thalamus and mamillary body. When TRH was administered to rats treated with pentobarbital, significant reversal was observed in the following structures: the lateral and ventral nucleus of the thalamus, dentate gyrus, caudate-putamen, nucleus accumbens, pontine gray matter, and raphe nucleus.

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Ependymal cells are known to react to pathological conditions, but only a few studies describing their reactive changes have been reported. In the present report the reaction of ependymal cells to stab injuries in adult rat brains was studied by the immunoperoxidase method using antiserum to astroprotein.
Although astroprotein is thought specific for astroglial cytoplasm and not present in ordinary, flat ependymal cells, the immunoperoxidase method demonstrated strong astroprotein immunoreactivity in the ependymal cells located close to the stab wound. These ependymal cells were cylindrical or tall cuboidal in shape and resembled tanycytes or developing ependymal cells which show positive immunostaining for astroprotein as well.
These findings suggest that ependymal cells react to simple stab injuries and regain the morphological as well as immunocytochemical characteristics of the more embryonic type of ependymal cells.

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In 22 autopsies of patients with hemorrhagic lesions in the thalamus, locations and extensions of the lesions were studied in detail. These lesions were classified into three groups; primary, secondary and mixed-type thalamic hemorrhages. In the primary group, a precise study of anatomical localization and extension led to further subgrouping into antero-lateral, postero-lateral, medial and extensive types. We also discuss clinico-anatomic and CT-anatomic correlations as well as correlations between the blood supply to the thalamus and the localization of the lesions. Four selected typical patient reports are presented.

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Intracranial pressure (ICP) and other related phenomena were monitored in 42 cases with various pathologic conditions to study the pathogenesis of rapid variations in ICP. Pressure waves appeared tc be closely related to changing respiratory patterns; the initial rises in pressure usually corresponded to suppressed movement in respiration, while the pressure reduction corresponded to hyperpnea and/or tachypnea. A transient fall in blood pressure also appeared coincident with the initiation of plateau-like waves. Such synchronized changes in vital signs associated with occurrence of pressure waves suggested o possible role of brain stem dysfunction.
In experimental pressure waves induced in 24 dogs with intracerebral expanding lesions, initiation of each pressure oscillation was also accompanied by a small fall in systemic arterial pressure as well a, weakened respiration. No distinct alterations in endotidal CO₂ and blood gas were detected. During these experiments, levels of sinus pressure revealed a positively synchronized oscillation corresponding tc small changes in ICP. At somewhat higher pressure levels, however, typical long-lasting pressure waves were accompanied by continued falls in sinus pressure.
Presumably brain stem dysfunction affects the initiation of pressure waves during intracranial hypertension and, further, the mode of venous outflow from the cranial cavity influences the duration and pattern of rapid ICP variations.

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A long-term study of 43 patients with aneurysms at the posterior communicating artery (PCoA) which had resulted in subarachnoid hemorrhage (SAH) was carried out. Twenty-nine of them survived for more than 6 months after common carotid ligation following SAH, and the other 14, who were conservatively treated, survived for more than 6 months after the last SAH, which had occurred before admission. In 18 of the patients long-term follow-up was discontinued because of death (due to rebleeding or other causes), but all the remaining 25 patients are still in the follow-up study. The mean period of follow-up was 9 years and 9 months. The shortest period of follow-up was 1 year and the longest one was 17 years. Fatal rebleeding was observed in one of 19 patients who had had total ligation of the common carotid artery. Rebleeding was observed in six of 10 patients who had had partial ligation, and fatal rebleeding was later observed in four of these six patients. Rebleeding was observed in six of the 14 conservatively treated patients, and fatal rebleeding was later observed in five of these six patients. Two patients in whom an increase in the size of the aneurysm was angiographically observed during the follow-up after common carotid ligation underwent successful direct operations. Judging from the results of this study, it was certified that total ligation of the common carotid artery for ruptured PCoA aneurysms controls rebleeding more effectively than partial ligation or conservative treatment.

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Although it is well known that the prognosis of child hydrocephalus has been improved by shunting operations, little is known about the question of why these children die after a long period. Between 1966 and 1980 at the Tokyo Medical College, the shunting procedure was carried out in 95 cases of infantile hydrocephalus. In 14 cases, death occurred more than three years after the operation for hydrocephalus. In eight cases an autopsy was performed. Six out of 14 cases died suddenly in spite of the shunt functioning well and these cases presented the so-called “hydrocephalic crisis”. On the other hand, eight cases deteriorated gradually and died despite the most intensive and ingenious neurosurgical care. The 14 cases were classified into two types as follows:
1) Sudden death type; most of the cases were combined with myelomeningoceles and the ArnoldChiari malformation or dysgenetic changes of the brain.
2) Gradual deterioration to death type; these cases were combined with intracranial inflammation such as severe meningo-ventriculitis. In the radiological examination of the skull, the posterior cranial fossa was studied. The index value was less than the lower limit (0.25) of the normal level by Schey's method, and a significant difference was observed. Sudden death cases always showed the picture of “hydrocephalic crisis” without any increase in the supratentorial pressure. Autopsy cases showed the posterior cranial fossa to be small and the clival slope to be steep, abnormal deformation of the condiloid, and a concentric osseous ring around the foramen magunum. Such an anatomically abnormal structure of the posterior fossa plays a role in producing an abortive form of craniocerebral dysproportion, together with the cerebral dysplasia such as the Arnold-Chiari malformation. The state of craniocerebral dysproportion is easily affected by elevation of the supratentorial cerebrospinal fluid pressure. These structural changes are the major factors causing acute compression of the brain stem.
On the other hand, gradual deterioration to death cases presented cerebral dysplasia and hydrocephalic change with severe meningoventriculitis. Inflammatory changes in the brain were observed extending even to the basal ganglia. Gradually irreversible changes of the brain structures are considered to be caused by repeated chronic intracranial inflammatin itself or by maldevelopment of the central nervous system and a decrease of immunological resistance of the host. The inflammatory changes of the basal cisterns and brain stem region may play a vital role in the gradually fatal outcome. Thus, the gradually deteriorating condition may be produced.

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Basal meningiomas were investigated using two-plane computed tomography (CT) with an ordinary section combined with a reverse section to ascertain the precise site of the origin, size, extension, properties and relation to adjacent tissue. Furthermore, with information obtained from angiography, operative difficulty and operative indications were investigated, to determine a therapeutic policy taking neurofunctional prognosis into consideration.
The factors directly affecting the operative difficulty were the large size of the tumor, deformity of the hypothamus and brain stem, supratentorial or infratentorial extension, bone erosion, calcification of the tumor, direct effect on the major vessels and high vascularity. It is considered to be difficult or impossible to perform operations in cases accompanied by more than three of these factors and, in the case of posterior fossa tumors, more than two.
Tumor density, extent of enhancement, perifocal low-density, ventricular dilatation, transtentorial herniation, brain or brain stem displacement, bone erosion on CT scans as well as tumor vascularity, feeding arteries, and changes in the major vessels on angiograms were also studied, and therapeutic problems as well as their countermeasures regarding these findings were discussed.
It is emphasized that obtaining more accurate information concerning the preoperative state is the first step towards the improvement of therapeutic results in basal meningiomas.

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Arachnoid cysts are common in the younger generation and most commonly found in the middle fossa, while those in the interhemispheric fissure have been rarely reported. Two adult cases of arachnoid cyst, one within the interhemispheric fissure and another one over the cerebral convexity, are presented. Protein content of the cyst fluid, 19.6 mg/dl and 9.0 mg/dl, respectively, was lower than that of the lumbar cerebrospinal fluid in each case.
Coexisting defects of the brain are not likely to represent the primary process; they seem to be the secondary results of an expansion of the cyst. The primary arachnoid cyst seems to be caused by a developmental error on the side of the arachnoid and not on the side of cerebral tissue.

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Familial occurrence of intracranial aneurysms in two sisters in association with rare cerebrovasculai anomalies is described. The aneurysms were located at the proximal and distal portions of the anterior cerebral arteries in these cases. The azygos anterior cerebral artery in one case and bilateral fenestration, of the vertebral arteries in the other were demonstrated as associated anomalies. These cases support the concept which suggests a hereditary basis for some intracranial aneurysms in addition to the congenita theory of aneurysm formation.

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Spontaneous intracranial hemorrhages caused by brain tumor are very rare. The authors experienced a case in which a 32-year-old male with an oligodedroglioma who exhibited a spontaneous intracranial hemorrhage including subdural, subarachnoid and intracerebral hemorrhaging. A brief review of literature on the mechanism of hemorrhage in patients with brain tumors, particularly glioma, was undertaken.

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A rare case of a 13-year-old boy with ossifying fibroma in the parietal bone is presented, and differential diagnosis from other fibro-osseous tumors such as osteoma and fibrous dysplasia is briefly discussed.
X-ray films of the skull showed a round, well-circumscribed osteoplastic lesion with a few radiolucent spots in its interior in the right parietal bone. Tomograms of the lesion revealed a smooth margin with an egg-shell appearance and some delicate streaks. Histological findings of this lesion showed osteoblastic rimming, some infiltration of xanthoma cells and lamellar bony structures.
Histological distinction between ossifying fibroma and fibrous dysplasia was emphasized.

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