Bleeding perimeters were normal. VDRL was positive at 0 dilution and FT ABS was also positive. ANA was negative. T4 was 5.3 with RT3U of 43.6, free T4 index was 3.2-.which is borderline low. TSH was normal at 3.5. CSF VORL was negative. Chest x-ray was normal. Selective cerebral angiography was done which confirmed a right frontotemporo- parietal infiltrating. neoplasm compatible with a glioblastoma: EEG done on 3/23/82 showed excessive slowing in the right hemisphere consistent with a mass effect. EKG was within normal limits. An The patient underwerit surgery. on 3/24/82 with complete excision of an angioma. The pathological evaluation revealed some atypical features and other regions were characteristic of ‘angioblastic meningiomas. The postoperative course was initially unremarkable, but on 4/2/82 she became febrile and developed bilateral pneumonia. She was treated initially with Mannitol and Erythromycin with rapid defervesence dnd improvement in her pulmonary function. She deve loped bronchospasm treated with inhaled sympathomimetics and Theophylline: preparations. The patient was discharged on 4/14/82 in much improved condition. Discharge medication included E-mycin, 250 mg, 2 pills 3-times daily afte meals; Synthroid,’ .15 mg ‘daily; phenobarbital, 60 mg 3 times a day and Theo-Dur, 300 mg, 3 times a day. The patient had been placed.on: thyroid suppression because nf her previous exposure to radiation in the Marshall Islands. The patient's positive VORL was treated: with Benzathine penicillin 2.4 million units IM in each buttocks after Benemid, 1 gram by mouth on thé day before discharge: She will be seen in the outpatient clinic in one week where repeat penicillin therapy will be given and again the following week. Hopefully, bronchodilators and Erythromycin can be discontinued at that time. She’ should remain on phenobarbital and thyroid replacement indefinitely. She will be seen-by myself-and Dr. Gonzalo Chong in the outpatient clinic. \ | 44) JOHN V. MICKEY, M.O. JVM/cb Dict: 4/19/82 Trans: 4/20/82 SD wd Co __\ (am) cD cy 38