Morphological aspects of the traumatic chronic subdural hematoma capsule: SEM studies.

The morphology of the outer and inner membranes of traumatic chronic subdural hematomas (CSDHs) surgically removed from eight patients was investigated by scanning electron microscopy (SEM). Hematomas were divided into three groups based on time that had passed from the initiation of trauma to surgery. Structure of the CSDHs showed gradual morphological changes of the developing hematoma capsule. They initially included angiogenic and aseptic inflammatory reactions followed by progressive involvement of fibroblasts-proliferating and producing collagen fibrils. Numerous capillaries suggesting formation of new blood vessels were observed mainly in young hematomas removed between 15 and 21 days after trauma. In "older" hematomas (40 days after trauma), more numerous capillaries and thin-walled sinusoids were accompanied by patent, larger diameter blood vessels. Within the fibrotic outer membrane of the "oldest" hematoma capsules (60 or more days after trauma), especially in the area over the hematoma cavity, blood vessels were frequently occluded by clots. The results suggest dynamic changes in cellular and vascular organization of traumatic CSDH capsules paralleling the progression in hematoma age.

Does apoptosis occur in amyotrophic lateral sclerosis? TUNEL experience from human amyotrophic lateral sclerosis (ALS) tissues.

The role that apoptosis plays in the pathogenesis of amyotrophic lateral sclerosis (ALS) is still unclear. From our autopsy samples, we have undertaken an effort to verify if apoptosis in ALS really occurs or if can at least be detected. The study was performed using TUNEL method for screening the apoptotic changes in the autopsy samples from 8 ALS cases compared with 16 control cases. No features of apoptosis (DNA cleavages) were noted in any of the investigated regions of the central nervous system in ALS cases as well as in controls. These preliminary results seem to support the reports, which deny the role of apoptosis in human ALS. The following investigations using additional methods will be performed for detection the apoptotic signals in ALS.

An attempt at evaluating borderline conditions of Parkinson's disease and its preclinical stage on the basis of clinical and morphological correlation.

The aim of the investigations was to find to what extent neurodegenerative changes develop in the brains of patients with no clinical symptoms of dementia, parkinsonism and other neurodegenerative diseases. It has been found that neurodegenerative pathology, as evaluated using immunohistochemical methods with monoclonal antibodies (Mab) against ubiquitin, tau protein, alpha-synuclein, and beta-amyloid, occurs more frequently than the presence of Lewy bodies. The degenerative changes involved the neurones of cerebral and cerebellar cortex, basal ganglia and medulla oblongata, where neurofibrillary tangles were found. Mab positive materials have been found in the cytoplasm of the cell body and the cell processes (axons) of the neurones and glial cells. Senile plaques, beta-amyloid positive, were frequently noted.

The heterogeneity of neuropathological changes in amyotrophic lateral sclerosis. A review of own autopsy material.

As an approach to the validation of different pathological findings in ALS, we have reviewed the histopathological slides of 24 cases (12 men, 12 women) of autopsy-confirmed ALS which had been treated in our centre (18 definite, 3 probable and 3 possible ALS). The mean age and survival was 57.1 years and 23.5 months respectively. The slides (from motor cortex, basal ganglia, brain stem and spinal cord) were reviewed with special attention paid to the severity of motor cortex and corticospinal tract degeneration, infiltrations of macrophages, atrophy of lower motor neurones, accumulation of lipofuscin, chromatolysis and gliosis. We also searched for the occurrence of axonal spheroids and various kinds of inclusions, like Bunina bodies, large hyaline, Lewy-body-like inclusions and even larger "hyaline balls", and ubiquitinated inclusions. The histological examination revealed considerable differences between particular cases. Different kinds of inclusions were found in 19 out of 24 cases. A shorter duration of the disease was found in the cases with numerous macrophages. The apparent histological degeneration of the motor cortex was found in cases with longer duration of the disease. However, the differences were not significant and no correlation between the occurrence of any type of inclusion or any other pathological finding and the duration of the disease was found. Whether apparent pathomorphological "heterogeneity" reflects some true differences in the pathogenesis of ALS is disputable.