Creutzfeldt-Jakob disease after Jannetta's operation with cadaveric dura mater graft: initial manifestations related to the grafted site

Nishida, Yasuhiro; Yamada, Masahito; Hara, Kazuma; Tsunemi, Tomohiro; Yamawaki, Masaru; Shimokawa, Reiko; Okeda, Riki; Tsutsumi, Toshiyuki; Mizusawa, Hidehiro

doi:10.1007/s004150200055

Cited by 12 publications

(17 citation statements)

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“…In the early disease stages, this finding may however be missing and follow-up exams should thus be performed [22]. Finally, a typical history of surgery may shift the diagnosis to iatrogenic CJD rather than sporadic or variant (Table 5) [7,9,22,30,31,34,44,[50][51][52][53][54].…”

Section: Discussionmentioning

confidence: 99%

MRI and clinical syndrome in dura materrelated Creutzfeldt-Jakob disease

Meissner

Kallenberg²,

Sánchez‐Juan

et al. 2009

J Neurol

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Section: Discussionmentioning

confidence: 99%

MRI and clinical syndrome in dura materrelated Creutzfeldt-Jakob disease

Meissner

Kallenberg²,

Sánchez‐Juan

et al. 2009

J Neurol

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“…Thus, the possibility of the coexistence of type 1 and type 2 PrP in the present cases cannot be ruled out. However, we believe these patients should be classified as MM1‐type CJD because all cases of dura‐CJD without florid plaques in which PrP type has been examined have shown type 1 PrP 15,20,29,36 . Some cases with florid plaques have shown type 1 PrP, 7,14,17,19 and some clinically atypical dura‐CJD cases with type 1 PrP have shown both synaptic‐ and plaque‐type PrP deposits 7,17 …”

Section: Discussionmentioning

confidence: 99%

Clinicopathologic characteristics of five autopsied cases of dura mater‐associated Creutzfeldt‐Jakob disease

et al. 2007

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We present five cases of dura mater-associated Creutzfeldt-Jakob disease (dura-CJD) that were analyzed clinicopathologically and review previous reports. The average age at dura mater transplantation was 54.4 +/- 7.3 years, and the average age at CJD onset was 66.0 +/- 8.2 years, with an average latency period of 11.6 +/- 1.1 years. The average age at death was 67.6 +/- 8.7 years, with an average CJD disease duration of 16.8 +/- 10.4 months. Symptoms of CJD onset in four patients who received dura mater transplantation below the cerebellar tent reflected cerebellar or brainstem dysfunction, whereas symptoms of one patient who received transplantation above the cerebellar tent reflected cerebral cortical involvement. All patients showed rapidly progressive cognitive impairment, and both periodic sharp-wave complexes on electroencephalogram and myoclonus were observed in the early disease stage. Neuropathologic evaluation showed one case of subacute spongiform encephalopathy and four cases of panencephalopathic-type CJD. Widespread cerebral neocortical, subcortical gray matter and cerebellar cortical involvement were observed to varying degrees, and severity tended to be associated with CJD disease duration. There were no instances of kuru plaques or florid plaques. Prion protein (PrP) immunostaining showed widespread synaptic-type PrP deposition. No differences between our dura-CJD cases and typical cases of sporadic CJD were found with respect to clinicopathologic findings, except history of dura mater transplantation. Although a specific association between the dura mater graft site and neuropathologic observations was not evaluated in the present study, the initial symptoms appear to be closely related to the graft site, indicating a direct transmission of CJD from the graft site to the adjacent brain.

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“…36 On experimental pressurized testing studies, dural defects repaired by suture alone leak at physiologic pressure ranges, whereas those repairs supplemented by tissue adhesives, i.e., fibrin glue, tolerated higher pressures. 7,12,13,[23][24][25][26][27][28][29]31,32,39,45,47,[52][53][54][55][56][57][58][59][60] In 1977, Chvapil commented on the plasticity of collagen matrices for the repair of biologic tissues, especially its porosity and its 3-dimensional matrix to encourage cellular in-growth. However, a failure rate of 3% occurred when the repair was augmented by fibrin glue.…”

Section: Discussionmentioning

confidence: 99%