Seven patients are presented who were treated for severe lead encephalopathy by massive bilateral cranial decompression.

Of the seven patients, five are alive. One of the fatalities resulted from gastrointestinal hemorrhage 1 week later although it is believed the encephalopathy was controlled.

There is recognized significant mental retardation present in two of the surviving patients although the remaining patients cannot be accurately evaluated at the present age. One of the two showing definite retardation also had craniosynostosis which may itself be associated with cerebral dysfunction.

A plea is made for more widespread use of decompression as a lifesaving measure and it is further suggested that the impairment of mental function following lead encephalopathy may be reduced if cerebral decompression is undertaken when it becomes apparent that the course of the disease is not being altered by medical agents.

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