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The patient, a woman aged 63, developed a visual disturbance, underwent radiation therapy for the pituitary tumor by a physician around March in 1963. After a temporary improvement she was treated with COGO for the tumor at the Radiation Department in our hospital in November 1963; she also suffered from the visual disturbanceAt the end of February in 1965 she suddenly developed a motor disturbance of her left arm and leg, and dysarthria. She was admitted to the Radiation Department in our hospital and was transferred to our department on 4/13/1965. At the transferred time neurological examination revealed a clear consciousness, a left homonimous hemianopsia, no papilledema, a left central facial paresis, protrusion of the tongue to the left on extension, and a flaccid paresis with impairment of discriminative sensation of the left arm and leg. One week prior to the surgery her right arm came to show weakness. The spinal fluid was under a pressure of 140 mm.H2O, and its protein was 61 mg.%. A plain skull roentgenogram revealed a ballooned-out sella turcica and typertrophia frontalis interna. The AP-view of a right carotid arteriogram showed no elevation of the A-1, and a positive proximal shift of the anterior cerebral artery to the left. The lateral view disclosed a remarkable backward concave at the A-2, and a slight upward displacement of M-2. The AP-view of a pnenimovenriculogram displayed a parallel shift of the Septum Pellucidum toward the left with a tilting of the upper margin of the 3rd ventricle to the left, the lower margin located in the midline. The PA-view of the pneumogram showed a slight displacement of the atrium of the right lateral ventricle toward the left side and an irregular shape of the posterior horn of the right side. Under the suspicion of a space taking lesion in the right hemisphere a large osteoplastic craniotomy was performed on the right side, revealing no space occupying lesion. The frozen section made from the occipital, parietal, and temporal area indicated degenerative necroses. Unfortunately the patient died of pneumonia postoperatively. The autopsy disclosed half moon-like scleroses with hyaline degeneration of collagenous fibers in arteries in the Sylvian fissure, a selective necrosis of the white matter of the right

S-14. A Case of Delayed Radionecrosis developed after Radiation Therapy for a Pituitary Tumor