Biomedical subjects
Publications and source records attributed to J Flament-Durand.
Ganglioglioma is an uncommon nerves-cell tumour (0.4% of all brain tumours). In 800 brain tumours in children, Garrido et al. (Toronto) found 14 gangliogliomas (1.7%). To our knowledge, ganglioglioma has not been reported in children under 2 1/2 years of age. We have incidentally discovered a ganglioglioma in a 3-day-old girl. Appearance on US, CT and MR are described and discussed.
The case of a solitary cerebellar abscess in a 36-year-old Rwandese male is described. First it was considered to be tuberculosis, but at microscopal examination of the lesion after neurosurgical excision the true germ was found: Blastomyces dermatitidis. This solitary intracerebellar blastomycosis abscess is only the fifth case reported worldwide and the first in African medical annals.
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An unusual case of traumatic aneurysm of the A-1 part of the anterior cerebral artery associated with a contralateral carotid-cavernous fistula is presented. Trapping of the fistula was carried out, and an attempt to repair the vessel wall was made. Thrombosis of the vessel occurred, but remained asymptomatic. Causes, physiopathology, and treatment of traumatic aneurysms are discussed.
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The reactivity of neurofibrillary tangles (NFT) of Alzheimer's disease with several antisera has been studied by immunocytochemistry. They were heavily labelled by an antiserum prepared against isolated NFT; the latter also remained stainable by Bodian-silver method. Some NFT were labelled on vibratome sections by an antimicrotubular protein but remained able to be counterstained by Congo Red, suggesting this labelling could demonstrate material trapped in NFT. The immunoelectron labelling shows that the abnormal filaments, straight as well as 'twisted', are the only structures recognised by the anti-NFT serum. This labelling was prevented only by pre-incubation with fractions enriched in NFT, confirming the presence of unique antigenic determinants in the latter.
Senile dementia of the Alzheimer type (SDAT) is a major problem in the human senescent population. As this pathology cannot be reproduced in animals, research into its development is greatly impeded. The technique of implantation of the nervous tissue has been utilized in order to establish an animal model and to test the possible existence of a transmissible agent. When human temporal cortex with Alzheimer's disease is implanted in the occipital cortex of 7-week-old rats, human cerebral tissue containing abundant tangles induces in the receiver cortex a reactive fibrous gliosis. In the processes of the astrocytes, twisted filaments are evident among bundles of normal filaments. These alterations could be induced by the metabolising of abnormal filament subunits or by some infectious agent introduced by the implant.
Enriched fractions of "tangles" obtained from cases of Alzheimer's disease have been observed by negative staining and platinum: iridium shadowing, and also after treatment with sodium dodecyl sulfate and urea. Abnormal filaments with a 80-nm periodic constriction exhibited a substructure consisting of six protofilaments. They also showed a periodic right-handed twist. Some fibrils with a 160-nm periodic constriction were made up of four protofilaments. These features are discussed in view of known fibrous protein models, especially neurofilaments.
Ten thousand children born consecutively in a university hospital were surveyed for the presence of major congenital malformations. About 2% (174) had a major congenital defect. Seventy-eight percent (135 of 174) of these malformations are associated with increased recurrence risk (greater than 1%), and 9% carry a high recurrence risk (greater than or equal to 10%). On the basis of the recurrence risk of 1% or higher and the feasibility of prenatal diagnosis, such a procedure should be considered in future pregnancies in 45% (79 of 174) of the mothers, especially inasmuch as 40% were primiparae younger than 36 years.
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A prolactin-secreting pituitary adenoma was removed in a 38-year-old man. The tumor was classified as a chromophobe adenoma on the basis of tinctorial staining, but immunocytochemistry revealed that cells reacted with anti-PRL serum. Electron microscopy showed secretory granules and evidence of high metabolic activity (well developed Golgi apparatus and rough endoplasmic reticulum). Immunoelectron microscopy by the immunogold staining method allowed a clear definition of prolactin containing granules.
Since the very start of using ultrasound to monitor pregnancy the information that the obstetrician has obtained from it has been great. Measuring the fetus (biparietal diameters, rump-crown length etc.) makes it possible to check development of the fetus in the uterus, as well as seeing the various organs and their placing and internal structure. Real time pictures make it possible to visualise the organs precisely from the point of view of their positioning and their internal structures. We report 12 cases of malformations of the central nervous system which were diagnosed in utero and we point out the value of early diagnosis in pregnancy. The 12 cases we found included four of hydrocephaly, one cyst of the choroid plexus, one hydrencephaly , two cases of holoprocencephaly and four cases of anencephaly. Since these malformations may be part of generalised malformations it is important to search for these others by ultrasound as well as by caryotyping and estimation of alpha-fetoprotein levels.
Cerebellar gliomas are the most frequently occurring tumors of the central nervous system in children and adolescents, but glioblastomas are definitely rare in cerebellum before twenty years of age. Only two histologically proven cases have been published in the international literature (1,2). We describe one new case and give a review of the literature.
Two siblings affected with partial trisomy 3p resulting from a maternal balanced translocation 46,XXt(3;10) (p21;q26) are reported. The clinical features of this syndrome are reviewed. The necropsy findings of the two siblings are discussed.
Ocular bobbing and myoclonus were unusual findings in a patient with central pontine myelinolysis. Pathological findings confirmed the diagnosis of pontine and extrapontine myelinolysis.
Operative findings of degenerative changes in pituitary adenomas are not uncommon; however, clinical apoplexy is rare. We report the case of a 43-year-old man who presents a sudden right hemiplegia with aphasia and right ophthalmoplegia, in relation with an ischemic pituitary apoplexy and cerebral vasospasm. A few cases of arterial obstruction or vasospasm associated with pituitary apoplexy have been reported in the literature. Cerebral arterial spasm has also been observed after pituitary surgery. Inclusion of blood or necrotic material in the subarachnoid space seems not to be the only mechanism of vasospasm. The role of hypothalamic dysfunction is considered.
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