Chronic neurogenic quadriceps amyotrophies.

Two cases of quadriceps amyotrophy, probably of chronic neurogenic origin are reported. Only the knee jerks were diminished, the calves hypertrophic, and the serum creatine kinase level very high in one case, and there were neurogenic electromyographic abnormalities in the quadriceps. In the first case, biopsy of the quadriceps muscle revealed a neurogenic origin with hyalinized hypertrophic fibres. CT scan showed abnormalities not only in the quadriceps but also in the sartorius, gracilis and gastrocnemius muscles. A second biopsy specimen from the gastrocnemius muscle showed histological findings similar to those of the quadriceps. In the second case, the EMG and biopsy findings suggested a myogenic origin, but 6 years later they were compatible with neurogenic atrophy. Differentiation from Becker dystrophy is very difficult in the first case and the second case is more a focal spinal amyotrophy. Further, in spite of their localization, the extension of the affected muscles changes the diagnosis. The same applies to chronic quadriceps amyotrophy in general, which cannot be regarded as an entity, but which suggests muscular dystrophy, spinal atrophy, polymyositis or a metabolic disorder. These cases can be compared with the four cases reported in the literature, which were regarded as a "forme fruste" of chronic spinal amyotrophy.

[Basilar trunk obstruction: report of 3 cases]. / Obstrução do tronco basilar: registro de tres casos.

Three cases of complete basilar obliteration are reported, ocurring at ages arteriosclerosis is unusual. The obliteration was verified angiographically in these three cases. The evolution was quite different in each one: "restitutio ad integrum", death, and definitive persistency of a locked-in syndrome.

Obstrucao do tronco basilar. Registro de tres casos. / Basilar trunk obstruction. Report of 3 cases

Registro de tres casos de obliteracao do tronco basilar, todos eles em uma idade em que a arteriosclerose e infrequente. O diagnostico foi confirmado angiograficamente. A evolucao foi diferente em cada um deles