Treatment of unruptured cerebral aneurysms still represents an unsettled question in neurosurgical and neuroradiological communities. Although nowadays the indication for treatment have become relatively clear, indeed uncertainity remains for what concerns the proper treatment modality (surgical or endovascular)in terms of both the risk and the mid and long-term efficacy of the two procedures. The ''Unruptured Aneurysms Italian Study'' is a cooperative prospective study which aims to delineate the ''State of the Art'' in a nation based population. It has been designed: 1) to depict the nationwide modality of treatment of Unruptured Aneurysms, 2) to assess in the most objective way the overall treatment-related mortality and morbidity as well as the surgical and endovascular risk in the respective patient populations (it is not a surgical versus endovascular study) and 3) to asses the efficacy of the different procedures in the mid and long term periods. The study started on June 2003 and to June 2006, 637 patients have been enrolled. The study will end when the 1000th patient is enrolled.

The central nervous system is traditionally considered an uncommon site for metastatic disease from female genital tract tumors. We report the case of a 48-year-old woman with malignant mixed müllerian tumor of the uterus, who developed spinal cord compression by epidural metastasis a few days after the diagnosis of the uterine malignancy. Emergency decompressive laminectomy was performed and a good recovery of the neurological function was achieved. In the following days, while submitted to extensive staging for the uterine malignancy, the patient complained of headache, confusion and visual disturbance. CT scan revealed multiple brain metastases. No other site of metastatic disease could be detected. The patient refused any further treatment and died 1 month later from progressive cerebral disease. Attention should be paid to the possibility of unusual distant metastases associated to uterine sarcoma in order to treat these patients promptly.

Compression of the glossopharyngeal nerve by the lateral choroid plexus of the 4th ventricle protruding excessively through the foramen of Luschka may be at the basis of some forms of glossopharyngeal neuralgia. This condition was observed in four patients. In one case, an anterior compression of the 9th nerve by a megadolic vertebral artery was also present. The condition was resolved in all patients by separating the nerve from the plexus and transecting it at the level of the foramen of Luschka.

The action of some extracts of human glioblastoma of the haemolytic complement of human and xenogeneic sera has been examined. The study suggests that the antigenic products of some human glioblastomas may induce an inhibiting effect on the haemolytic complement of human, as well as xenogeneic (rat and rabbit), sera. The inhibiting action on the xenogeneic sera is indicative of the presence of species-specific antigens or tumor cells, comparable to that of normal tissues.

A preliminary definition of light absorption spectra of brain neoplasm represents a correct approach to the laser therapy of cerebral tumours. The goal should be the identification of those oncotypes more sensive to the laser energy, allowing consequentely a dosage of the energy proportional to the light absorption coefficient, reducing any side effects.

We report the case of a 4th ventricle hematoma due to rupture of an angioma localized in the cerebellar vermis, in an eight-year-old child. Only seven cases of a vascular malformation in such a localization, angiographically and/or pathologically verified, have been previously reported. The girl died, in spite of prompt surgical treatment. Also the clinical presentation of this kind of case is very rare.

A case is reported in which the peritoneal catheter of a ventriculoperitoneal shunt migrated into the chest cavity causing an hydrothorax. The three similar cases drawn from the literature are reported.

The action of human fresh and lyophylised human dura mater on rat, rabbit and human serum complement has been analyzed with the aim of confirming and comparing the species-specific antigenicity of both substances. The results demonstrate that both fresh and lyophylised human dura mater induce a complement consumption on rat and rabbit serum. The phenomenon is related to the species-specific antigenic activity of the tissue, and it is only partially decreased by the lyophylisation procedure. The residual antigenic activity, however, doesn't limit the use of this material as a graft for dural defects repairs in humans.

In predicting Ar+ laser-neural tissue interaction a determination of the optical absorption properties of brain parenchyma appears indispensable. In this study a determination of absorption spectra of different areas of rabbit brain at the wavelength of an Ar+ laser beam is made. The areas considered in the study are frontal and occipital gray and white substance, thalamus, basal ganglia, cerebellar cortex and choroid plexus. Specimens of these areas measuring 2×3×3 mm were obtained from coronal sections 1 cm thick of 20 rabbit brains. The analysis of optical properties was made by means of a photoacoustic spectrometer which appears the only suitable technique for testing the optical absorption properties of biological materials. The absorption coefficient results were similar in magnitude and constant in all the areas examined, measuring approximately 50 cm−1. The prediction of lack of any selective effect for the different areas is confirmed by the sizes of lesions made in cerebral specimens of the same areas of the contralateral hemisphere by means of Ar+ laser: the lesions increase in size in proportion to the increase in output power and exposure time, independently of the areas considered. Also the histological examination of the areas shows the same morphology to be independent of the variations of both output power and exposure time. The only differences were the presence for short exposure time and low output power of a carbonized layer inner to the layer of coagulative necrosis.

Five cases of malignant cerebellar astrocytoma observed during a seven-year period are reported. The analysis of the cases allows us to conclude that malignant cerebellar astrocytoma represents a true tumoral entity quite distinct from cerebellar glioblastoma as well as from medulloblastoma. A perfect correspondence between the histological malignancy and the duration of survival has been noted in all the cases.