Balzac's 'Pierette'. An early description of chronic subdural hematoma.

In his novel Pierrette, written in 1840, Balzac describes a case of chronic subdural hematoma, including its traumatic origin and surgical treatment. The description was written at a time when subdural hematoma was not seen as a separate clinical entity, and was generally thought to be the result of inflammation.

Balzac's serous apoplexies. The hesitant acceptance of the discovery of the cerebrospinal fluid by Magendie.

The diagnosis of a "serous apoplexy," customary in the first half of the 19th century, was based on the lack of knowledge regarding the normal presence of the cerebrospinal fluid. Balzac's descriptions of three cases of serous apoplexy draw our attention to the fact that the discovery of the cerebrospinal fluid by François Magendie was not assimilated into clinical medicine until the second half of the 19th century.

Enolase isoenzymes in human gliomas.

Gamma-enolase (one of the three possible subunits of the dimeric enzyme enolase (EC 4.2.1.11)) has been reported as a marker for human neurons. Studies investigating the presence of gamma-enolase in human gliomas have given conflicting results, but a definite finding is important for further studies of the biology of these tumors and the possible use of gamma-enolase as a marker for tumors originating in nervous tissue or for neuronal damage. Using electrophoresis of tumor tissue extracts as well as immunohistochemistry the authors have demonstrated the presence of gamma-enolase in human gliomas. Analysis of the gamma-enolase content in the plasma of patients with brain neoplasms further revealed that, although this enzyme may be present in the tumor itself, its concentration in blood is not a reliable marker for a tumor of the human central nervous system.

Cerebral hemorrhage from unsuspected choriocarcinoma.

A patient is presented who developed a frontal intracerebral hemorrhage, which proved to be due to a metastasis of a choriocarcinoma. The patient's uterus and adnexa had been removed two years previously for a non-malignant disorder. two years previously for a non-malignant disorder. The authors stress the importance of cytological examination of the bloody fluid on evacuation of a hematoma.

[Value and limitations of the study of gamma-enolase in cerebrospinal fluid as evidence of neuronal degeneration]. / Intérêt et limites de l'étude de la gamma-énolase dans le liquide céphalo-rachidien comme témoin de la dégradation neuronale.

Elevation of the gamma-chain of the glycolytic enzyme enolase in the cerebrospinal fluid has previously been reported as a parameter for neuronal damage. The authors evaluated this by measuring gamma-enolase in the CSF of a number of patients with neurological disease known to produce neuronal damage, using a commercial radioimmuno-assay test kit. All measurements were done when gamma-enolase levels had been reported to be maximal during the course of the disease. The results suggest that, as a parameter for neuronal damage, gamma-enolase is not as reliable as reported. An elevation of gamma-enolase in the CSF seems to reflect serious disease; this could be important in differentiating encephalitis caused by Herpes Simplex virus from other viral encephalitides. A normal level of gamma-enolase does not exclude severe neuronal damage.

Enolase isoenzymes in human cerebral metastasis.

gamma-Enolase [one of the three possible subunits of the dimeric enzyme enolase (EC 4.2.1.11)] has been reported as a marker for human neurons, neuroendocrine cells and tumors derived from these cells. In recent years, however, its presence has been reported in nonneuronal tumors. For employment in the histopathologic diagnosis of tumors of the nervous system, exact knowledge of the enolase isoenzyme patterns occurring in these tumors is a prerequisite. In human gliomas, the presence of varying quantities of gamma-enolase has been demonstrated. The present study examines the enolase isoenzyme pattern in human cerebral metastases of various primary progeny, using electrophoresis of tumor tissue extracts as well as immunohistochemistry. Additionally, a number of primary tumors of nonneuroepithelial tissue was examined by immunohistochemistry. The presence of gamma-enolase was demonstrated in a significant number of brain metastases. A relation between enolase isoenzyme pattern and survival after operation for brain metastasis could not be found. For histopathologic diagnosis of tumors of the adult human central nervous system, analysis of the enolase isoenzyme pattern is not reliable.