After the capture of Fortress Louisbourg by the New England Irregulars, Louis XV of France commissioned Jean Baptiste Louis Frédéric de la Rochefoucauld, due d'Anville, to command a massive offensive flotilla to retake Louisbourg, and ravage the eastern seaboard of North America south to Florida.

After arriving in Chibouctou (Halifax Harbour) following thirteen weeks at sea. due d'Anville collapsed. His doctor treated him with enemas and emetics, but he suddenly turned blue, convulsed, and died.

The report of his autopsy, which included the cranium, (and which is Canada's only Royal autopsy) had been lost for two centuries. It is now analysed, showing that although he had significant intracranial pathology, he died from medical therapy.

Occasionally patients in the stroke age-bracket over 40 have unexplained transient cerebral is chemic attacks in association with normal cerebral angiograms. From this group 120 have been collected in whom the transient episodes resembled the neurological accompaniments of migraine. According to symptoms, the patients were categorized as follows: Visual accompaniments (patients with only ordinary scintillating scotoma were excluded), 25; visual and paresthesias, 18; visual and speech disturbance, 7; visual, and brain stem symptoms, 14; visual, paresthesias, and speech disturbance, 7; visual, paresthesias, speech disturbance and paresis, 25; recurrence of old troke deficit, 9; miscellaneous, 8. In establishing the diagnosis angiography is advisable in all but classical cases. Typical of migrainous accompaniments are the buildup and migration of visual scintillations, the march of paresthesiae, and progression from one accompaniment to another, characteristics that do not occur in thrombosis and embolism. Diagnosis is facilitated when 2 or more similar episodes have occurred or migraine-like scintillations are present. Headache occurred in 50% of cases. Other cerebrovascular processes, coagulation disorders, and cerebral seizures must be ruled out.

GABA receptor binding in fifteen regions of cat central nervous system was investigated immediately postmortem and at twelve, twenty-four, and 72 hours postmortem. In each of the supraspinal areas studied, GABA binding increased with time-after-death. Changes after 24 hours occurred in the cerebellum, the visual cortex, the sensorimotor cortex. and the amygdala where more than a twofold increase in binding was observed. Increases were also noted in the thalamus, caudate nucleus, hippocampus, and hypothalamus. The results suggest that caution should be exercised in the interpretation of GABA binding data obtained from human brains that have not been treated in a similar postmortem manner.

Continuous 48-hour polygraphic recordings of sleep/waking patterns were performed on 14 patients with narcolepsy-cataplexy before and after 7-10 days of treatment of their nocturnal sleep with gamma-hydroxybutyrate (GBH). GBH improved the quality of night sleep by increasing the amount of slow wave sleep, reducing stage I, increasing sleep efficiency (percentage of time in bed spent asleep), and reducing the number of periods of short sleep under 15 minutes. Also nighttime REM sleep was reduced in latency and became less fragmented. The daytime period contained less slow wave sleep and REM sleep, and fewer episodes of prolonged sleep. Patients experienced reduction or loss of daytime attacks of irresistible sleep, cataplectic attacks, and other auxiliary symptoms. Residual daytime drowsiness subsequently improved on low doses of methylphenidate. Tolerance did not develop and there were no serious toxic side-effects. Four of the patients had been refractory to previous combinations of antidepresents and high doses of stimulants.

This study is based on 28 personal cases. Twenty seven cases of infantile hemiplegia and one case of Sturge- Weber syndrome, with uncontrollable epilepsy and severe behavior disturbance, were subjected to hemispherectomy. Any evidence of a defect in the other hemisphere was a contraindication to operation. In nine cases the left cerebral hemisphere was removed. Following the operation, epilepsy and behavior disturbances were abolished in nearly all of the cases. In those with left hemispherectomy there was no speech disturbance before or after the operation.

It is postulated that at birth all cerebral funtions including consciousness, speech, and movement are bilaterally represented, but to unequal degrees. With training and education these functions become more lateralized. Thus, we can explain the greater plasticity of the brain in childhood.

A female child, TK, was born January 12, 1965, and was initially admitted to the Hospital for Sick Children, Toronto, on January 13, 1972, at age seven years with a sevenday history of runny nose, earache, headache, and fever. On the day before admission, she had a grand mal seizure and lumbar puncture revealed purulent cerebrospinal fluid (C.S.F.) which grew pneumococci. She was treated with antibiotics, her meningitis resolved, and she was discharged home nine days after admission.

Twenty-two patients were carefully defined as having progressive dementia without other known cause and not complicated by clinical or laboratory evidence of multiinfarct dementia. Their degree of dementia measured by the ESD correlated highly with EEG disturbance (r=-0.79). The LPRS correlated 0.73 with ventricular enlargement. Although the EEG and CT scan only correlated significantly with each other in advanced cases, a combined index of EEG and CT Scan change, (Physical Meaasures Index) achieved a correlation of 0.93 with a combined index of psychological change (Psychological Measures Index). The results indicate the possibility of using physical and psychological measures to monitor quantitative change in Alzheimer's Disease, the EEG contributing more initially and the CT scan more in the most advanced cases.

Necropsy findings consistent with spongiform encephalopathy of the Creutzfeldt-Jakob type are described in the brain of a 48-year-old woman whose prolonged course and clinical features had suggested Alzheimer's presenile dementia. Six other members of her family in two generations have also died of progressive presenile dementing illnesses of Alzheimer type, lasting 5-10 years.

Autopsies showed a post-viral temporal lobe encephalopathy in one and spongiform (C-J) lesions in another. Neuropathological studies in this family add weight to the idea that Alzheimer's disease and Creutzfeldt-Jakob disease represent different manifestations of a genetic predisposition to “slow virus” encephalopathies.

Experiments were conducted to evaluate the effect of various durations of 1-Hz brain stimulation on kindling behaviour induced by 60-Hz sine wave stimulation. In two experiments the effective threshold intensity (ETI) to elicit a convulsion was determined on four separate occasions with 5 days of daily trials interspersed between determinations. On each day experimental rats were stimulated with I-Hz current on the first and third trials for 5, 15, 30, 60, 120, 180, or 600 seconds duration and with 60-Hz current for 30 seconds on the second trial. A steady increase in the intensity required to elicit a convulsion with 60-Hz current from ETI2 to ETI4 resulted for all rats with durations of 15 seconds or greater. Rats stimulated only with 60-Hz sine waves, and those in the 5 second group, maintained relatively stable values from ETI1 to ETI4 with a slight decline occurring. Suppression of convulsive behavior on daily trials was modest in the 15 second group, pronounced with the 30 second group, and drastic with the other groups. The 600 second group had the greatest suppressive effect operating. The suppression effect did not appear to be due to tissue damage inasmuch as most of the experimental rats (except the 600 seconds one) convulsed again at previous low ETI levels following a 15 or 16 day rest at the end of the experiment. This result suggests that the suppression effect is a relatively transient event.

The prevalence of Horner's syndrome in the MS patient population is 2 - 3%. Using pharmacologic testing in three patients the lesions were localized to the central or intermediate sympathetic neurons. It is likely that demyelination of the central sympathetic neuron accounts for this probable manifestation of MS.

Subdural empyema is a serious intracranial infection. C. T. scanning is the most accurate examination method in this disease. Increasing reliance on C. T. scanning makes it important to realize that even an enhanced scan may produce a false negative result, as outlined in this case.

A case is reported of traumatic chronic extradural hematoma in a child who had previously undergone a craniotomy for a different lesion. Perforations made in the bone flap served as vents for extrusion of the hematoma fluid into the subgaleal space, thus decompressing the intracranial space. This resulted in a benign clinical course.

A case of hereditary sensory neuropathy is described resembling Dyck's Type I hereditary sensory neuropathy. Sensory testing revealed marked pain impairment in feet and hands shading at mid calf to normal at mid thigh and shading above the wrist to normal at the elbow. Other sensory modalities including temperature were intact except painful heat and painful cold and they produced very little if any discomfort. Stimuli at 0° C or 45° to 70° C elicited a temperature response but not pain. Sural nerve biopsy findings (including elecironmicroscopy) were consistent with a diagnosis of Type I hereditary sensory neuropathy, but also showed evidence of abortive axonal regeneration and profound Schwann cell vacuolation.