"Sticky platelet syndrome": a congenital platelet abnormality predisposing to thrombosis?

We have identified a number of patients with coronary artery disease, TIAs and/or strokes and idiopathic ischemic optic neuropathy who have a platelet population which is in vitro hyperaggregable with epinephrine and ADP and hyperresponsive to surface contact. These patients have no identifiable risk factors. Several families have been identified in which multiple members had these findings.

Primary differentiated neuroblastoma of the orbit.

A 49-year-old woman had a 12-year history of a localized left orbital tumor that required five subtotal excisions, orbital radiotherapy, and finally an exenteration. The last procedure was performed after visual function had deteriorated and in order to prevent spread of the tumor into a surrounding compartment. The biopsy specimens from the first four surgeries showed a stroma-free spindle cell tumor with benign cytologic features and no mitotic activity, which exhibited palisading of nuclei, imbrication of delicate cytoplasmic processes (neuropil), true perivascular rosettes with cytoplasmic processes oriented perpendicular to vessel walls, and Wright rosettes.

Pupillary sparing oculomotor palsy from acute subdural hematoma.

An acute subdural hematoma presented as a partial third nerve palsy with complete pupillary sparing. The patient was alert and oriented, and except for a subtle hemisensory hypalgesia, there were no other neurologic signs. Preoperative diagnosis was made by CT scan and cerebral angiography.