A 65-year-old woman developed progressive, bilateral ophthalmoplegia, with thickened extraocular muscles on CT. One month later, a cardiac arrhythmia led to her death. Pathologically, the extraocular and skeletal muscles showed diffuse mononuclear cell inflammation, while the heart contained granulomatous myositis. This patient's syndrome of idiopathic, orbital myositis and giant cell myocarditis may be a distinct nosologic entity.

We analyzed the clinical features of symptomatic posterior cerebral artery (PCA) stenosis in 6 patients selected from 15 patients with angiographically documented PCA atherostenosis occurring during a 7‐year period. Transient ischemic attacks (TIAs) were the major presentation in 5 patients. A homonymous visual field defect was present in 2 patients. TIA symptoms were predominantly visual or sensory, or both. The most common visual symptom was difficulty seeing to one side. One patient saw flashing lights. Sensory spells were always paresthetic, usually involving the arm and hand and occasionally the face and leg. Three patients had visual and sensory spells together. Two patients with a visual field defect had calcarine infarcts found by computed tomography. All patients were treated with warfarin. During followup (4 months to 4 years), no patient had a new stroke in the PCA territory, and only one continued to have TIAs. PCA atherostenosis is rarer than PCA embolic occlusion. In contrast to those with PCA embolism, our patients with PCA atherostenosis had more TIAs and fewer infarcts. The clinical features of PCA stenosis—preponderance of visual and sensory TIAs‐distinguish this vascular lesion from stenosis of the middle cerebral artery.

A patient with a focal brainstem abscess in the region of the zona incerta developed a chronic oculocephalic dyskinesia in which paraoxysmal tonic skew deviation and torsion of the eyes were coupled with ocular oscillations and head tilt.

Patients with orbital aspergillosis commonly present with unilateral proptosis and associated sinus disease. However, neither of these manifestations was observed in a 62-year-old woman who had an orbital apex syndrome with visual loss, complete ophthalmoplegia, and corneal hypoesthesia. Pathologic examination of a specimen from a granulomalike mass removed at left frontotemporal craniotomy showed branching hyphae with the characteristic appearance of Aspergillus.

1.(1) A new technique for sectioning whole animal brains for cryostat and routine pathologic sections is described. The advantages of this technique are: (i) Distortion by fixation and removal of brain and orbital tissues from the cranial vault and orbit is avoided. This is particularly important in fluorescence studies. (ii) Each frozen slab can be viewed grossly under UV illumination to select areas for microscopic study. (iii) With this technique, it is possible to return to a previously frozen block or slab for further study. (iv) The state of orbital and cerebral circulation remains the same as at the time of sacrifice. 2.(2) Comparison of the appearance of the sections after various amounts of free fluorescein was injected was compared with the appearance after giving standard amounts of protein-bound fluorescein. Free fluorescein in the amounts of 0.3 ml of a 5% solution injected in the femoral artery produced the same results at any time interval from 30 sec to 6 hours. Free fluorescein sections gave better results after fixation by perfusion at the termination of the experiment. Small amounts of free fluorescein and standard amounts of protein-labeled fluorescein compare favorably by eliminating microscopic over-fluorescence while preserving their ability to demonstrate pathologic conditions. Microscopic studies of the optic nerve proved that over-fluorescence with large amounts and percentages of fluorescein made it impossible to differentiate between normal and pathologic material. Gross (macroscopic) study of cold injuries to the brain, however, proved that only with relatively large amounts of fluorescein could the site of injury be seen. 3.(3) Further work is planned to include brain swelling and its relationship to papilledema and vascular occlusive phenomenon in the brain and orbit. These studies may well indicate that variations in the amount and type of fluorescein may be necessary to achieve the desired results under different experimental conditions.