Biomedical subjects
Publications and source records attributed to E Reusche.
A 3-year old patient with a spinal cord astrocytoma is presented. The clinical signs, diagnosis, neurosurgical, morphological results and prognosis are discussed. If there is any suspicion of an intraspinal abnormity, short-term neurological controls, somato-sensory evoked potentials and MRT of the spinal cord should be performed.
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A haemangioma extending from the first thoracal vertebra into the extradural spinal canal presented clinically as slowly progressive incomplete cord compression. Radiographic, myelographic, and CT findings are demonstrated and an additional lumbar vertebral haemangioma was found. The study of magnetic resonance imaging (MRI) done by spin-echo technique indicated that signal intensities within the vascular malformation measured in various recovery (TR) and echo times (TE) are largely the result of different blood flow velocities.
According to the clinical classification of amyotrophic lateral sclerosis by Hemmer its "hemiplegic type" is described from two observations in 37 personal cases. The peculiar difficulties of differential diagnosis especially with the hemiplegic type of multiple sclerosis in two further cases are discussed in detail. Four cases of "Mills' syndrome" are compared. "Mills' syndrome" has been assumed to be a slowly progressive, unilateral ascending or descending variant of amyotrophic lateral sclerosis. A study of Mills' original papers and evaluation of personal observations leads to a more critical assessment. In Mills' original cases, widely different entities such as multiple sclerosis, syphilis, and parkinsonism are included besides amyotrophic lateral sclerosis. In the light of the investigations presented here, Mills' syndrome seems to be merely an obsolete clinical term.
An unusual case of a malignant teratoma of the right optic nerve with extension into the chiasm is presented. The preoperative diagnosis was difficult to establish. Complete removal of the lesion with postoperative irradiation was carried out. Eight months after the operation, the patient developed subarachnoid metastases by the cerebrospinal fluid pathway as well as systemic metastases and died. No local recurrence of the tumor was seen at autopsy. The therapeutic possibilities for these lesions are discussed.
A single dose of 40 mg triamcinolone acetonide was injected intrathecally in 30 patients with multiple sclerosis and 20 with other neurological diseases. In 15 of them the endogenous cortisol level was determined on three successive days and their cerebrospinal fluid examined before the triamcinolone injection was given. Cortisol levels were then measured serially for another 15 days after the injection. Contrary to the response after intramuscular injection, the endogenous secretion of cortisol was not significantly depressed after intrathecal administration. The latter is, therefore, suggested in the treatment of inflammatory diseases of the central nervous system and its integuments, and for acute exacerbations of multiple sclerosis.
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CNS tissue and peripheral organs of 50 autopsy cases with chronic renal failure (CRF) and dialysis treatment were evaluated for aluminum- (Al) containing argyrophilic inclusions using the Howell and Black method modified by Reusche. Morphological alterations were correlated with the duration of hemodialysis (HD) and to the amount of prescribed Al-containing drugs for better control of hyperphosphatemia. Significant correlations were found between the degree of morphological alterations and Al intake up to 2.5 kg (p = 0.0003), as well as for morphology and duration of longterm HD up to 178 months (p = 0.001). Most sensitive structure for CNS deposits were choroid epithelia, followed by glial cells and neurons. Autonomic ganglia, heart, ovary/testis, parathyroid, adrenal, and pituitary demonstrated reliably peripheral deposits. Al-containing drugs, administered preferentially during HD, explain the additional significance of Al uptake and duration of dialysis (R-Qu. = 0.6697). The deposition of Al-containing proteinaceous inclusions is apparently irreversible. After renal transplantation, with termination of drug-related Al intake and normalized renal Al excretion, the Al-induced argyrophilic degradation products remained in the cellular cytoplasm in unchanged fashion up to 10 years.