The aim of this paper is to present our experience with CT guided stereotaxy, documenting the types of procedures performed and their outcome. Over the past five and a half years, 600 stereotactic procedures have been performed using the Brown Roberts Wells (BRW) stereotactic system. The procedures were categorized as (i) diagnostic biopsies : 431; (ii) Therapeutic procedures (Aspirations) : 52; (iii) functional procedures: 13; and (iv) stereotactic craniotomies: 104. False negative or nondiagnostic biopsies were obtained in 28 out of 431 diagnostic procedures (6.5 percent) and in 3 cases the procedure was terminated without taking a biopsy. Two of 483 patients undergoing stereotactic biopsy or aspiration died due to procedure related complications (0.41 percent). Seven patients had major morbidity associated with this procedure (1.44 percent) and 12 others had transient worsening of neurological status (2.48 percent). All functional procedures were done for movement disorders. Stereotactic craniotomies were performed for excision of small lesions in eloquent areas. Of 600 procedures, the preoperative objective was achieved in 564 cases (94 percent). Stereotactic surgery has very low mortality and morbidity and plays an important role in the management of intracranial lesions.

A series of 44 consecutive patients with aneurysms of anterior communicating (A. Com.) artery during an 8 year period, during which 80 patients with 91 aneurysms were operated, is being reported. It comprised 55.0 percent of all aneurysms operated during this period. Eight patients (18.2 percent) had multiple aneurysms. Twenty seven A.Com. aneurysms (61.4 percent) were directed anteroinferiorly, 8 aneurysms (18.2 percent) posterosuperiorly, 6 aneurysms (13.6 percent) superiorly and 3 aneurysms to the side. Twenty nine. A.Com. Aneurysms (65.9 percent) arose at dominant A1-A.Com. junction. All cases were treated by direct surgery. The results are encouraging, though mortality overall was 15.9 percent. Good grade cases made satisfactory recovery. Direction of aneurysm at AC-A.com. and its bearing on surgical outcome is stressed. Most of the posterosuperior pointing aneurysms presented in poorer grades and outcome was unsatisfactory. In comparison most of anteroinferiorly pointing aneurysms presented better grades and results were satisfactory.

Functional differences between the two cerebral hemispheres were assessed by the Wagner Preference Inventory (WAPI-II). Hemispheric preference pattern of 12 occupational categories were determined by testing a large sample of 1140 adult subjects on WAPI-II. Identifiable cerebral preference patterns emerged for seven occupational groups. Categorization in terms of four different functions of the two hemispheres yielded more refined information. WAPI-II appears to be a quick and valid neurobehavioralmeasures of cerebral dominance, useful to neuropsychologists.

Serum Vitamin E was estimated in twenty two consecutive patients of spinocerebellar degeneration. Serum vitamin levels were found to be normal in all these patients. Role of Vitamin E in spinocerebellar syndrome is discussed.

Nine patients with traumatic epidural haematoma (EDH) have been reported and literature reviewed. Drowsiness was present in 5, dullness in 3 and papilloedema in 2 cases. Four patients had hemiparesis. The thickness of the haematoma was 1.6 cms in one and 4.3 cms in another while in the rest it was 1.6 cms or less. Patients with minor head injury (Glasgow Coma Score [GCS] 13-15) with mild clinical symptoms in static or recovery phase and minimal signs presenting late after 36 hours of injury, where CT scan reveals diffuse haematoma (rather than localised one indenting on the brain) of thickness less than 1.5 cms without midline shift may be managed without surgical intervention only if facilities for close observation are available. Surgical evacuation is the gold standard for all extradural haematomas when there is any doubt

Craniopharyngioma present on the CT scan with cysts, calcification and contrast enhancing solid tumour. The cysts are usually hypodense and do not enhance with contrast. Hyperdense cysts are rare. The cause of the high attenuation values on CT is thought to be a high protein content of the cyst fluid. The authors present three cystic craniopharyngioma that were hyperdense on the CT Scan.

One case of Dandy - Walker cyst associated with occipital meningocoele is presented. In this case magnetic resonance imaging demonstrated a Dandy - Walker cyst in direct communication with an occipital meningocoele. Occipital meningocoele might simply be an expression of increased intracystic pressure in Dandy-Walker cyst in embryonic life, or such association might suggest morphogenetic situation during embryogenesis.

Various kinds of physical and cognitive acts and different sensory inputs to the brain have been described to induce reflex epilepsy. Usually simple sensory stimuli or motor acts precipitate epilepsy. Rarely, however more specific sensory stimuli orcomplex motor or cognitive acts have been known to do so. We report a case of reflex epilepsy following the act of micturition. In this patient, generalised tonic-clonic seizures have occurred independently as well as after the initiation of act of micturition. The CT scan and EEG were suggestive of right frontal lobe focus, a finding extremely rare to have association with reflex epilepsy of any known nature. The possible mechanisms of reflex stimulation have been discussed.

A rare case of juvenile Huntington's disease manifesting since the age of seven years is reported. The inheritance was typically autosomal dominant as three other members on the paternal side died of similar disease. A definite family history can becrucial in the diagnosis of juvenile Huntington's disease

A three year female child presented with right proptosis of two months duration with destruction of bony walls of the right orbit, the tumour extending to surrounding sinuses, nasopharynx and middle cranial fossa. Biopsy of the tumour revealed non-Hodgkin's lymphoma, diffuse mixed type

A case of spinal cord compression due to an enterogenous cyst is described.