Aneurysm in the anterior communicating artery always presents diagnostic difficulties of a clinical and sometimes neuropathological nature. The authors describe the anatomic aspects of 21 cases of this type of aneurysm, together with the clinical background: anatomic recognition of clinically undetected aneurysms is not always straightforward. An inferior frontal inter-hemispheric hematoma suggests the diagnosis, but only macroscopic dissection of the whole hematoma and large vessels allows confirmation. Histological examination often reveals a hemorrhagic lesion in the fronto-polar area. Clinical investigation of these cases shows the reasons for certain classic diagnostic errors. Although this exercise reveals no original concepts, it draws attention to some classic facts that are often unexplainably overlooked. An uncommon speech disorder is described in two cases, but the mechanism of development is not clear.

Adolescent↗

PubMedDate not supplied

[Dementia in diffuse cortical Lewy body disease].

Diffuse Lewy body disease has not been yet described in France, although some authors, essentially Japanese ones reported cases of this disease. A man began at age 56 to be very apathetic with memory disturbances. Later, he developed aphasia, stereotypies, and mild parkinsonian rigidity. He died in cachexia, three years after the onset of the disease. Post-mortem examination showed diffuse senile plaques and tangles in the cortex. But there was also a striking widening of Lewy bodies, in the pons and in the frontal, temporal and cingular cortex. These Lewy bodies were located in the 5th cortical layer, and their immature and irregular shape made them difficult to identify. The authors discuss the role of each lesions on the clinical disturbances, in regard to other described cases.

Alzheimer Disease↗