Stroke related to cerebral amyloid angiopathy: the significance of systemic vascular disease.

A retrospective postmortem analysis of 25 cases of cerebral amyloid angiopathy (CAA) in the setting of Alzheimer's disease or senile dementia of the Alzheimer type (AD/SDAT) is reported. Seven patients experienced clinically significant cerebral infarcts or hemorrhages or both. There was no statistically significant difference in the incidence of infarcts or hemorrhages in hypertensive and nonhypertensive patients.

Eosinophilic fasciitis with porphyria cutanea tarda and progressive destructive arthritis.

The course of arthritis with eosinophilic fasciitis is poorly documented. We report a patient in whom polyarthritis preceded the clinical appearance of eosinophilic fasciitis and progressed over a 14-year period to a destructive process with inflammatory and degenerative characteristics. Porphyria cutanea tarda and transient extramedullary pancytopenia complicated this patient's disease.

Histopathological features of recurrent pleomorphic xanthoastrocytomas: further corroboration of the glial nature of this neoplasm. A study of 3 cases.

Pleomorphic xanthoastrocytoma (PXA), a tumor most often presenting superficially over the cerebral hemisphere of young subjects, has certain morphological similarities to fibrous histiocytoma (or fibrous xanthoma) of the meninges and brain, namely the occurrence of lipid-laden neoplastic cells and, frequently, a dense reticulin fiber network. The detection of glial fibrillary acidic (GFA) protein in the tumor cells helped to establish its astrocytic derivation, but it has been advanced that, in spite of this agreed observation, the tumor should still be regarded as a fibrous xanthoma of meningeal origin. Although many patients have a long symptom-free postoperative survival, local recurrences at varying intervals after surgery have been noted in some instances.

The influence of Encephalitozoon cuniculi on neural tissue responses to implanted biomaterials in the rabbit.

Laboratory rabbits are commonly used for testing the tissue response of neural device biomaterials. Rabbits of many colonies in the U.S.

Sex hormones modulate the response of pulmonary perivascular inflammation to cyclophosphamide therapy in MRL/MpJ-lpr/lpr mice.

Responses of pulmonary perivascular infiltrates to immunosuppressive therapy with cyclophosphamide (CY) were evaluated in the MRL/MpJ-lpr/lpr (MRL/1) mouse, a model for the study of systemic lupus erythematosus. Male and female mice were divided into the following groups: controls injected with saline; intact mice receiving CY; castrated CY-treated mice; castrated, hormone implanted, CY-treated mice. CY treatment began at 30 days of age and animals were killed at 60 days of age.

Central pontine myelinolysis: a complication of hyponatremia or of therapeutic intervention?

We report four cases of central pontine myelinolysis (CPM) that illustrate important features of the disorder. The condition is described mainly in the neurological literature and, to our knowledge, is not discussed in the forensic science journals. This disorder must be recognized and understood by the forensic science expert who addresses issues of liability.

Cerebrospinal fluid centrifuge analysis in primary amebic meningoencephalitis due to Naegleria fowleri.

We describe a case of primary amebic meningoencephalitis due to Naegleria fowleri. This is the first reported case, to our knowledge, in Missouri. Emphasis is placed on the morphologic identification of degenerating amebas in a cytospin preparation of cerebrospinal fluid using Wright's stain during the rapidly progressive meningoencephalitic stage.

Saccular aneurysm associated with segmental duplication of the basilar artery. A morphological study.

Saccular aneurysm associated with segmental duplication (also called "fenestration") of the basilar artery is an anomaly that results from an embryonic fault. Reports of the treatment of the aneurysmal component have only recently appeared in the neurosurgical literature, and little has been written on the morphology of this anomaly. This study answers the need for information about its structure to the extent permitted by the examination of a single specimen.

Bilateral diaphragmatic paralysis as a possible paraneoplastic syndrome from renal cell carcinoma.

Bilateral diaphragmatic paralysis is rare. We describe a patient with bilateral diaphragmatic paralysis who died 18 months after initial presentation and who was found to have renal cell carcinoma. At autopsy, no intrathoracic tumor was found that would explain the diaphragmatic paralysis.

Primary malignant nerve sheath tumor of the gasserian ganglion: a report of two cases.

Primary tumors of the gasserian ganglion are usually benign, and secondary tumors are malignant. We report two cases of a malignant primary tumor of the gasserian ganglion, bringing the total in the world literature to five. The presentation, etiological features, and treatment of these cases are reviewed, together with a review of the literature.

Septate bifrontal ependymal cyst. Case report.

The authors describe the case of a septate ependymal cyst involving both frontal lobes. The clinicopathological features, treatment, and results of previously reported cases are reviewed, and the etiology and pathogenesis of these cysts discussed.

Central nervous system involvement as a presenting feature of acute monocytic leukemia: preceding leukemia by 12 months.

This report describes a patient who presented with a diffuse malignant central nervous system (CNS) process composed of cells with monocytic differentiation one year before the development of acute monocytic leukemia. A similar presentation has been documented for acute lymphocytic leukemia, but to the best of our knowledge, this is the first report to detail a diffuse CNS malignancy as the presenting symptom for acute monocytic leukemia.

Intracranial hemorrhage produced by spontaneous dissecting intracranial aneurysm.

Two patients with intracranial dissecting aneurysms were seen initially because of acute hemorrhage. One patient died, and a false dissecting aneurysm secondary to atherosclerosis was found at autopsy. In the other patient, the appearance of the carotid arteriogram was typical of a dissection.

Sudden visual loss and a chiasmal syndrome due to an intrachiasmatic vascular malformation.

A 48-year-old woman presented with a chief complaint of visual loss and bitemporal hemianopia. A similar episode of temporal visual field loss had occurred 34 months earlier and spontaneously resolved. Computerized tomography demonstrated a suprasellar mass.

Peripheral neuropathy associated with monoclonal gammopathy. Studies of intraneural injections of monoclonal immunoglobulin sera.

A causal relationship between paraproteinemia and neuropathies has been suggested. We studied three patients with chronic sensorimotor polyneuropathy associated with plasma cell dyscrasia and monoclonal gammopathies (IgGK, IgMK, IgA lambda). Sural nerve biopsies showed mild (2 cases) to moderate loss of myelinated fibers (1 case).

Disulfiram neuropathy: a neurofilamentous distal axonopathy.

Disulfiram is used to treat alcoholism and is known to cause peripheral neuropathy: few reports of biopsied human nerves have revealed axonal degeneration and loss of myelinated fibers. We studied a 22-year-old woman with severe sensorimotor neuropathy following treatment with disulfiram for 6 months. Histologic studies of the sural nerve revealed a neurofilamentous axonopathy with rare enlarged axons distended by neurofilaments.

Neoplastic angioendotheliosis: a clinicopathological entity with multifocal presentation. Case report.

Neoplastic angioendotheliosis is a rare disorder characterized by intravascular neoplastic proliferation of endothelial cells within vessels of all caliber in the meninges and neuropil. Ischemic infarcts of brain and spinal cord result from occlusion of the lumina by neoplastic cells of fibrin thrombi. Transition from reactive to neoplastic endothelium can be identified in many vessels.