The blister-like aneurysm appeared to be a laceration of the carotid wall based on degeneration of the internal elastic lamina.

No abstract

Surgical material taken from the 'outer layer' of thickened dura mater (dural band) at the craniovertebral junction of eight cases of syringomyelia with Chiari type I malformation was histologically examined in comparison with four autopsy cases as controls. The dural band was thickened and there were increased numbers of collagen fibers which showed fiber splitting, hyalinous nodule, calcification and/or ossification. These changes were not observed in the four control cases. Thus, it is suggested that the thickening of the dura mater may be a causative factor of syringomyelia with Chiari type I malformation. In addition, the histology of the thickened dura mater suggests the condition may be a consequence of birth injury in these patients.

1. Two experimental models designed to reflect different aspects of vascular dementia (rats with cerebrovascular occlusion and rats with cerebral embolization) and stroke-prone spontaneously hypertensive rats (SHRSP) have been evaluated. The focus was on SHRSP as a model for vascular dementia.2. Neuropathological data revealed that the cerebrovascular disorder in SHRSP was associated with lesions in their brains similar to those seen in typical human cases of multiple cerebral infarction.3. SHRSP that died from cerebral infarction exhibited behavioural changes, including increased activity and disrupted circadian rhythms, which might correspond to the state of delirium observed in patients with dementia. 4. SHRSP displayed cognitive impairments in a step-through passive avoidance task. 5. When compared to age-matched Wistar Kyoto (WKY) rats, both conscious and anaesthetized SHRSP had significantly decreased cerebral spinal fluid (CSF) levels of acetylcholine (ACh).6. These findings suggest that the SHRSP might serve as a suitable animal model for vascular dementia in humans caused by cerebrovascular lesions.

A 27-year-old male presented with a very rare metastasis to the vertebral body from a cardiac pheochromocytoma manifesting as a pathological fracture of the C-4 vertebral body that occurred while playing golf. The patient was initially treated with hard collar fixation. Gallium scintigraphy demonstrated multiple hot spots in the mediastinum, the frontal bone, the vertebral column, and the rib. Magnetic resonance imaging of the chest delineated a cardiac tumor. The patient underwent biopsies of the cardiac and the frontal bone lesions. The diagnosis was malignant cardiac pheochromocytoma with multiple bone metastases. Initial irradiation of the cardiac and the vertebral lesions was followed by surgical intervention to the cervical spine to prevent aggravation of the kyphotic deformity and spinal cord compression. Preoperative embolization of the feeding arteries was followed by C-4 corpectomy, iliac bone grafting, and anterior titanium plating fixation. The patient was discharged and returned to work. However, 20 months later, he died of a metastatic brain lesion with systemic tumor progression.

Giant cell glioblastoma (GCG) is one of a group of rare tumors in which the cell population is abnormally large and includes multinucleated cells of gigantic sizes. Immunohistochemical studies were performed on four GCG cases and found that all giant cells and/or tumor cells were positive for glial fibrillary acidic protein (GFAP), S-100 protein, and vimentin, thus verifying the tumor's glial origin. The nuclei of multinucleated giant cells of three adult cases were frequently immunostained for proteins expressed during the cell cycle (proliferating cell nuclear antigen (PCNA) and Ki-67), thereby demonstrating the proliferative capacity of these cells. By contrast, those of a 12 year old girl expressed these cell cycle markers rather infrequently. Alpha I-antitrypsin was detected with relatively high frequency in the giant cells, and its presence may explain their bizarre sizes and pericellular reticulin fiber formation. A literature review of 32 cases revealed that the GCG that occurs preferentially in young girls is a type of pleomorphic xanthoastrocytoma. By contrast, GCG in adult males has the same age incidence as ordinary glioblastomas and, as these, expresses high levels of cell cycle-related proteins. Thus, GCG, which is subclassified morphologically as ordinary glioblastoma, has distinct biological and clinical characteristics, with that in children requiring re-evaluation because of its similarities to pleomorphic xanthoastrocytoma.

No abstract

SUMMARY In order to elucidate the behavioral changes related to stroke, ambulatory activity and water drinking were observed in stroke-prone spontaneously hypertensive rats (SHRSP). Age matched male SHRSP and Wistar Kyoto rats (WKY) were subjected to a 12 hour light and dark alternation cycle. Ambulation and drinking activity counts were determined simultaneously with an Ambulo-Drinkometer. Before stroke, ambulation and drinking activity counts in the dark phase (82%) were higher than those in the light phase (18%). Both parameters were well synchronized with the light and dark alternation cycle. With aging, daily ambulation decreased while daily drinking activity increased in SHRSP and WKY. Daily ambulation and drinking activity in 15 and 30 week old SHRSP were greater than those of WKY. It was demonstrated with an Ambulo-Drinkometer that SHRSP undergo specific behavioral changes before the onset of stroke. For instance, the 40-60 week old SHRSP showed significant individual variation in both ambulation and drinking activity. This desynchronization with the light and dark alternation cycle was followed by stroke. Twenty seven autopsies showed 11 cerebral infarctions, 10 cerebral hemorrhage and 6 cerebral hemorrhage with infarctions to be the causes of death. Stroke Vol 16, No 1, 1985 STROKES IN HUMANS occur abruptly due to underlying diseases including essential hypertension and cerebral artery sclerosis.' A retrospective analysis of stroke patients from the literature 2 -3 reveals that approximately 75% of the patients demonstrated cerebral infarctions and 11 % demonstrated cerebral hemorrhages. The lethal course of stroke in stroke-prone spontaneously hypertensive rats (SHRSP) established by Okamoto et al 4 coincides well with the lethal course of patients with cerebrovascular lesions.5 " 7 Yamori et al 5 has classified stroke-related behavioral changes in SHRSP from a symptomatical point of view. No reports are available in the literature, however, concerning the behavior of SHRSP during their entire life span. In order to identify prodromes of stroke, the present study was carried out to observe the behavioral pattern changes throughout the SHRSP life span (including the development period of hypertension, the onset of stroke and death). Thus, a chronobiological analysis of the behavioral changes in SHRSP was performed. MethodsWe used SHRSP and WKY donated by Prof. Dr. Okamoto, Department of Pathology, Kinki University School of Medicine. Age-matched male SHRSP and male WKY were subjected to a 12 hour light (L) and dark (D) alternation cycle (LD). Illumination was provided by fluorescent light (100 Lux). Room temperature was maintained at 22 ± 2°C throughout the experiment. Rats were fed a regular diet