The blister-like aneurysm appeared to be a laceration of the carotid wall based on degeneration of the internal elastic lamina.

No abstract

Surgical material taken from the 'outer layer' of thickened dura mater (dural band) at the craniovertebral junction of eight cases of syringomyelia with Chiari type I malformation was histologically examined in comparison with four autopsy cases as controls. The dural band was thickened and there were increased numbers of collagen fibers which showed fiber splitting, hyalinous nodule, calcification and/or ossification. These changes were not observed in the four control cases. Thus, it is suggested that the thickening of the dura mater may be a causative factor of syringomyelia with Chiari type I malformation. In addition, the histology of the thickened dura mater suggests the condition may be a consequence of birth injury in these patients.

1. Two experimental models designed to reflect different aspects of vascular dementia (rats with cerebrovascular occlusion and rats with cerebral embolization) and stroke-prone spontaneously hypertensive rats (SHRSP) have been evaluated. The focus was on SHRSP as a model for vascular dementia.2. Neuropathological data revealed that the cerebrovascular disorder in SHRSP was associated with lesions in their brains similar to those seen in typical human cases of multiple cerebral infarction.3. SHRSP that died from cerebral infarction exhibited behavioural changes, including increased activity and disrupted circadian rhythms, which might correspond to the state of delirium observed in patients with dementia. 4. SHRSP displayed cognitive impairments in a step-through passive avoidance task. 5. When compared to age-matched Wistar Kyoto (WKY) rats, both conscious and anaesthetized SHRSP had significantly decreased cerebral spinal fluid (CSF) levels of acetylcholine (ACh).6. These findings suggest that the SHRSP might serve as a suitable animal model for vascular dementia in humans caused by cerebrovascular lesions.

A 27-year-old male presented with a very rare metastasis to the vertebral body from a cardiac pheochromocytoma manifesting as a pathological fracture of the C-4 vertebral body that occurred while playing golf. The patient was initially treated with hard collar fixation. Gallium scintigraphy demonstrated multiple hot spots in the mediastinum, the frontal bone, the vertebral column, and the rib. Magnetic resonance imaging of the chest delineated a cardiac tumor. The patient underwent biopsies of the cardiac and the frontal bone lesions. The diagnosis was malignant cardiac pheochromocytoma with multiple bone metastases. Initial irradiation of the cardiac and the vertebral lesions was followed by surgical intervention to the cervical spine to prevent aggravation of the kyphotic deformity and spinal cord compression. Preoperative embolization of the feeding arteries was followed by C-4 corpectomy, iliac bone grafting, and anterior titanium plating fixation. The patient was discharged and returned to work. However, 20 months later, he died of a metastatic brain lesion with systemic tumor progression.