Occlusion of the third ventricle by tortuous, bulbous, calcified basilar artery

A married man, 59 years old, registered at the Mayo Clinic on February 12, 1957, because of marked mental disorientation. He apparently had been in reasonably good health until December 1956, when he suffered what was called a “stroke.” He felt ill, lay down on the ground, and vomited. He was not paralyzed after this episode, however. At this time, hypertension was discovered. Attempts at treatment with drugs failed because of lack of cooperation on the part of the patient. A month before his admission, edema of the legs developed and became progressive to a rather marked degree. Examination by the patient’s local physician disclosed auricular fibrillation. The patient was hospitalized in his home city two weeks before admission to the clinic, and digitalis and diuretic agents rid him of much of the edema. Apparently, the patient had experienced no neurologic symptoms until about mid-December of 1956. A t that time, it was noted that he was becoming confused. He became disoriented for several hours and then seemingly recovered orientation completely. However, in the ensuing three or four weeks, he had repeated episodes of confusion. The patient was confused as to time and place and was unable