Clinical features of acute infarcts in the anterior cerebral artery territory are correlated to the topography of lesions on CT Scan in 15 patients. The most common clinical feature, hemiparesis with crural dominance correlated well with the involvement to the contralateral paracentral lobule in all 12 patients. Patients who had facio-brachial weakness and hemiparesis showed infarcts limited to the periventricular white matter around anterior horn of lateral ventricle. Large medial-basal frontal lesions were associated with behavioural disturbances in 5 patients. In 3 patients who had patchy lesions involving the paracentral lobule, supplementary motor area and medial frontal areas with sparing of the fronto-polar areas had bladder disturbances in3 patients, while 3 other patients who had involvement of the same areas did not show bladder disturbances. The size of the infarct seems to have not much correlation as compared to the site and structures involved. Supplementary motor area lesions had associated speech disturbances like mutism, transcortical motor aphasia and decreased nonfluent verbal output, in one case each. Clinical features in anterior cerebral artery territory have more often fair correlation with topographic lesions on CT.

Over the last 10 years from 1982-1992, we have diagnosed 29 cases of multiple sclerosis at our centre. In this hospital based retrospective study, 22 cases were definite (including 4 cases of Neuromyelitis optica) and the remaining 7 were probable cases of multiple sclerosis according to Poser's criteria (Poser et al 1983). There was no sex preponderence. Striking clinical presentations included high incidence of optic nerve, brain stem and spinal cord involvement. Sympathetic disturbance in the form of Horner's syndrome was seen in two patients. Major depressive psychosis was an associated disease in 2 cases. One patient developed multiple sclerosis after receiving anti rabies vaccine.

We evaluated the efficacy of Propofol administration in attenuation of the cardiovascular response prior to scalp incision and compared it with the administration of an additional dose of intravenous thiopentone. Thirty patients between 15-50 years of age undergoing elective craniotomy were randomly allocated into 3 groups of 10 each. Group 1 (normal saline) served as control while in group II 2.0 mg/kg of thiopentone was given one minute before scalp incision and in group III propofol 1.0 mg/kg was given one minute before scalp incision. Group I and II patients showed significant tachycardia and hypertension. Rise in heart rate was 26 percent and 9 percent and rise in systolic blood pressure was 21 percent and 13 percent in groups I and II respectively. The changes in cardiovascular parameters in group III were minimal and insignificant except for 12 percent fall in systolic blood pressure one minute after propofol administration. Hence, propofol administration effectively attenuated haemodynamic responses to scalp incision while an additional doses of thiopentone offered only a transient and incomplete protection.

Eighty six C. T. scan proven cases of intracerebral hemorrhage were studied. The mean age was 58 ñ 14.5 years with the majority (65 percent) of the patients in the 5th and the 6th decades. Our data revealed that the state of alertness and the prognosis had a significant correlation with the location, the volume of hemorrhage, presence of ventricular communication and the degree of mass effect. The mortality was 43 percent and the survivors improved significantly at the time of discharge.

This study is a report of neurological cases in a teaching hospital during the year 1991. Out of 2,34,021 new patients seen in the hospital, 1153 (0.49 percent) were referred to the neurology clinic. 27.6 percent were above 40 years of age. 70 percent in this age group were males and 30 percent were females. The common disorders observed were episodic and paroxysmal group (45.3 percent) followed by extrapyramidal and movement disorders (19.5 percent), nerves, nerve root and plexus disorders (9.4 percent), diseases of the spinal cord (7.5 percent) and other (18.3 percent). Among the diseases epilepsy was the commonest (20.6 percent) followed by cerebrovascular accidents (19.1 percent) Parkinson's disease (16.9 percent) alcoholic cerebellar degeneration (3.7 percent), Polyneuropathies (3.7 percent) etc. Cerebrovascular accidents were predominantly reported among the males (P < 0.05). Age specific proportion of cases increased significantly with increasing age for vascular syndromes in cerebrovascular diseases, extrapyramidal and movement disorders. However, epilepsy and headache syndromes declined significantly with the increasing age (P < 0.05).

Tuberculous spinal arachnoiditis (TSA) is a serious condition and its early diagnosis is imperative. This communication is on 3 patients in whom the computerised tomography (CT) and water soluble myelographic appearance in TSA is highlighted. In twopatients, this was found to be superior in the diagnosis of TSA than plain myelography. On CT-myelography, TSA is characterised by a 'beaded' appearance and a denser concentration of the contrast medium in the ventral subarachnoid space.

Fibrous histiocytoma of the cervical spine is extremely rare. This lesion was accidentally discovered in a patient who had presented with a history of cervical trauma. The diagnosis was subsequently confirmed on histopathological examination following surgery.

A case of child who developed mutism following surgery for medulloblastoma is described. Recovery was spontaneous.