[Amyotrophic lateral sclerosis]. / Stwardnienie zanikowe boczne (SLA).

The literature on amyotrophic lateral sclerosis from the years 1995/96 is reviewed including the topics of the World Congress of Neurology in Buenos Aires in September 1997. The problems of a) changed criteria of diagnosis and course of SLA after the time of the first definitions by classical neurological authors, b) the concepts concerning the aetiology and mechanisms of the disease, c) the present studies on drugs and their tentative clinical applications are discussed.

Embryonal carcinoma of the pineal gland with yolk sac tumor differentiation. A case report.

Twenty three old male patient was diagnosed as a pineal gland tumor and was operated in neurosurgical ward. He died four weeks later due to pneumonia and respiratory failure. Clinical diagnosis was based on computer tomography (CT) and magnetic resonance image (MRI) examination. Histological study of a biopsy and autopsy specimens showed embryonal carcinoma with yolk sac tumor differentiation. The diagnosis was supported by positive cytokeratin, placental alkaline phosphate and alpha-fetoprotein immunostainings.

[A case of fatal hemolytic-uremic syndrome with central nervous system manifestations]. / Przypadek zespolu hemolityczno-mocznicowego ze zmianami w ukladzie nerwowym.

Twelve years old girl who died from haemolytic uraemic syndrome (hus) on post mortem neuropathological examination showed cerebral purpura and demyelination focus with glial-mesenchymal reaction. The problem with factor is responsible for cerebral lesions, direct allergic reaction causing hus or uraemia in consequence of acute renal failure but also activating allergic processes, is discussed.

Vascular malformations associated with other congenital anomalies of the central nervous system: coexistence and possible causal relations.

Two cases of vascular malformations coexisting with other congenital defects of the central nervous system (CNS) are presented here. The first patient was a 14-year-old girl mentally retarded who demonstrated seizures and balance disturbances with onset in early infancy. The neuropathological examination revealed vascular malformations in the pons, diastematomyelia (triple central canal) in the sacral spinal cord and palleocerebellar granular layer dysplasia. The second patient was a 10-year-old boy hospitalized because of purulent dermatitis who suddenly developed recurrent generalized and focal motor seizures. The neuropathological examination disclosed multiple capillary teleangiectases with focal anomalies within cerebral cortex of the frontal and parietal lobes. The relations between several developmental anomalies in the CNS and possible causal relation between such malformations are discussed.

[A case of coexistence of meningioma with intracranial aneurysm in a patient with ruptured aortal aneurysm]. / Przypadek wspólistnienia oponiaka i tetniaka sródczaszkowego u osoby z peknietym tetniakiem aorty.

Fifty-three-year-old woman was admitted to hospital with tetraplegia symptoms and died two hours later. Clinical diagnosis was: cerebral stroke, hypertension in anamnesis. Postmortem examination showed ruptured dissecting aneurysm of thoracic and abdominal segment of aorta, meningioma of right pontocerebellar angle and saccular aneurysm of left inferior, posterior cerebellar artery. The diagnostic difficulties and hypotheses of formation of multifocal of different changes are discussed.

[Arteriovenous malformation as the most frequent form of cerebral vascular dysplasias]. / Malformacje tetniczo-zylne najczesciej spotykana postacia dysplazji naczyniowych mózgu.

The purpose of the study was a survey of autopsy and biopsy material from 27 cases of cerebral vascular malformations for establishing the occurrence of various forms of these lesions in relation to that reported from other centres. It was tried also to check in the light of the morphological analysis of our cases the theory of vascular malformation development put forward by Kaplan et al (1961). The material comprised 4 cases of telangiectasia, 11 arteriovenous malformations, 7 cavernous haemangiomas and 5 mixed cavernomas with arteriovenous malformation. Arteriovenous malformations prevailed. The clinical manifestations set in at the age between 15 and 46 years. The analysis rather confirm the concept of Kaplan et al. that dysplasia is derived from disturbances in the development of capillaries in early embryogenesis. All other comparisons and observations were consistent with those reported in literature outside Poland.

[Effect of chemotherapy for neoplasms on the central nervous system in children]. / Wplyw chemioterapii w przebiegu choroby nowotworowej na osrodkowy uklad nerwowy u dzieci.

Lesions to the central nervous system were studied in twenty children, aged 1-12 years decreased because of neoplastic disease of internal organs and treated with cytostatics. The young age of the patients allowed to attribute the observed changes to this disease. Several damaging factors occurring during its course were analysed. Lesions were found in cerebral and cerebellar cortex; walls of blood vessels were also damaged. We may conclude that chemotherapy prolonging the survival of children allowed the development of encephalopathy and modified its picture.

[Intravenous treatment with streptokinase of acute myocardial infarction. II. Effect of patency of the artery supplying the infarction area on the infarction size and post-infarction impairement of left-ventricular function]. / Dozylne leczenie streptokinaza swiezego zawalu serca. II. Wplyw droznosci tetnicy zaopatrujacej obszar zawalu na mase zawalu i pozawalowy ubytek czynnosci lewej komory.

153 patients with a first acute myocardial infarction underwent the study. 90 of them received 1.000.000 units of streptokinase intravenously, followed by intravenous heparin administration for 5-7 days. The control group consisted of 63 remaining. In all patients serum CK-MB activity was determined every 4 hours for 72 hours: the infarct mass was calculated from the obtained curves. In 118 patients selective coronarography and left ventriculography was performed in the 2-nd or 3-rd week of hospitalisation. Left ventricular ejection fraction (E.F.) and dyssynergy index were calculated from ventriculographic data. Coronarography revealed a patent infarct-related artery in 76.7% of patients treated with streptokinase and in 44.4% of the control group (p less than 0.001). Among patients with a patent infarct-related artery an early peak of serum CK-MB activity (suggesting early recanalisation) occurred in 72.2% of streptokinase patients but in only 42.1% of the control group. Patients with a patent infarct-related artery had a significantly lower infarct mass (45 +/- 28 g vs 56 +/- 30 g), a lower left ventricular dyssynergy index (229 +/- 243 vs 348 +/- 247) and a significantly higher E.F. (63 +/- 12% vs 54 +/- 15%) compared with patients with an occluded artery.

[Intravenous streptokinase treatment of acute myocardial infarction. I. Effect of the treatment on the course of infarction and the patency of the artery supplying the infarction area]. / Dozylne leczenie streptokinaza swiezego zawalu serca. I. wplyw leczenia na przegieg zawalu i droznosc tetnicy zaopatrujacej obszar zawalowy.

128 consecutive patients with a first myocardial infarction, admitted within 4 hours after the onset of an angina pain, were divided into two groups according to the history of the peptic ulcer. Group I (with a negative history, n = 72) received intravenously 1,000,000 units of streptokinase followed by intravenous heparin infusion for 5-7 days. Group II (with a positive history, n = 56) was the control one. In hospital mortality was 2.8% in group I and 5.3% in group II (N. S.). Coronarography performed during second or third week of hospitalization revealed the patency of a coronary artery supplying an infarcted region twice as frequent in group I than in group II (78% vs 41%, p less than 0.001). Percentage of patients with the early serum peak of CKMB activity (from 8 to 12 hours from the start of therapy) suggesting early recanalization of a coronary artery supplying an infarcted region was significantly higher in group I (44.7% and 70.1%) than in group II (7.8% and 19.5%). Both differences between groups were significant (p less than 0.001). Early serum peak of CKMB activity (from 8 to 12 hours from start of treatment) was stated respectively in 46.5% and 81.4% of patients of group I in which subsequent coronarography revealed the patency of a coronary artery supplying the infarcted region.

[Neuropathologic analysis of 8 undiagnosed cases of cerebral cysticercosis]. / Analiza neuropatologiczna 8 nie rozpoznanych przyzyciowo przypadków wagrzycy mózgu.

The presented material comprised 17 cases observed in four Warsaw hospitals in a period of 20 years. Nine patients with the pseudotumour syndrome were diagnosed correctly and referred to neurosurgical services. The remaining eight cases died in neurological hospital departments with the following clinical diagnoses: cerebral stroke 3, subarachnoid haemorrhage 1, comatose state preceded by dementia 1, chronic meningoencephalitis 1, status epilepticus 2 cases postmortem investigations demonstrated cerebral cysticercosis in all cases. In four patients with predominant symptoms of cerebrovascular disease lesions were found of the type of residual vasculitis cysticercosa, the sequelae of which might have caused secondary complications independent of concomitant arteriosclerosis. Dementia appeared in a patient with huge hydrocephalus consequent to numerous cysticerci. The patient with the diagnosis of meningoencephalitis had an inflammatory reaction of the ependyma and meninges caused by a cysticercus floating in the IV ventricle. Of the patients dying in status epilepticus attention is called to a 6-year-old girl with a solitary cysticercus localised subcortically in the motor area. The authors suggest that the possibility of cysticercosis should be kept in mind, despite its rarity, in cases with a not completely clear clinical manifestations of cerebrovascular disease, chronic meningoencephalitis and epilepsy or dementia.