A case of autoptically verified progressive subcortical gliosis (PSG) is reported. The 79 year old woman developed subacutely a right sided hemisyndrome and a cerebellar syndrome. Generalized action myoclonus of the left leg evolved into left sided Epilepsia partialis continua and dementia appeared. After a 6 month course the patient died of aspiration pneumonia. There was no indication of alcoholism or HIV-dementia neither clinically nor at autopsy. Morphologically the brain showed a diffuse proliferation of astrocytes in the subcortical white matter, thalamus, basal ganglia, brain stem and cerebellum. A severe neuronal dropout was found in medial thalamic neurons but Wernickes encephalopathy was ruled out. 21 cases of PSG confirmed by autopsy were found in the literature. Clinics, neuropathology and classification of PSG is discussed.

100 divided samples of cerebrospinal fluid were examined by micro-electrophoresis and conventional paper-electrophoresis. Results of the two tests agreed well for gamma-globulin, albumin, alpha1 and beta fractions, but poorly (because of methodological differences) for pre-albumin, alpha2 and tau fractions.

For clinical trials classification of stroke should be possible at the bedside by simple methods that are available every where. In this study are 1105 patients with every first ischaemic strokes and 130 patients with intracerebral haemorrhages. The differences between severity of clinical symptoms, outcome and risk factors of intracerebral haemorrhages, ischaemic stroke caused by cerebral microangiopathy, ischaemic stroke combined with extracranial carotid stenosis, cardiogenic brain embolism and atherothrombotic stroke, were analysed. Intracerebral haemorrhages show the poorest outcome of all groups (mortality 23.8%), due to increased intracranial pressure. Cardiogenic brain embolism is more frequent in older women (mean age 77.8 y.). Main risk factor is atrial fibrillation with absolute arrhythmia. The outcome of this group is the worst of all subgroups of ischaemic stroke and survivors most often in need of institutionalization. Patients with ischaemic stroke combined with extracranial carotid stenosis are significantly younger (mean age 67.6 y.), predominantly male, and smokers. Their mortality is low (0.63%), but recovery of paresis is slower than in other subgroups. Ischaemic strokes caused by cerebral microangiopathy with hypertension as main risk factor recover most quickly but acute mortality is higher than in ischaemic stroke combined with extracranial carotid stenosis because of higher age (mean age 74.5 y.). Institutionalization is more frequent too because of higher incidence of dementia in this subgroup. The main prognostic factors of all groups are age and severity of clinical symptoms. A special subgroup are infratentorial ischaemic strokes.(ABSTRACT TRUNCATED AT 250 WORDS)

Normals are able to move their limbs in a continuous spectrum of speeds. In contrast patients with so called extrapyramidal disorders show typical changes of movement. Short ballistic movements of the upper limb were analysed by a joystick connected with a computer in 57 patients with different extrapyramidal disorders (parkinsonsyndrome, essential tremor, torsion dystonia, chorea and intention tremor) and in 22 normals. Patients with parkinsonsyndrome and with torsion dystonia move the upper limb slower than normals and all other patients. Their movements show breaks. All patients execute aimed movements less precisely than normals. Most unprecise are the movements of patients with essential tremor. Oscillation of movements of all patients deminish, but less than in normals. Patients with parkinsonsyndrome show smallest oscillations at the beginning of each movement. Patients with intention tremor differ not from normals at the beginning, but show still the highest oscillations at the end of movement. Holding the target they correct most frequent. We discuss, that striatum generates timing and strength of ballistic movement and cerebellum apeases oscillation of movement and frequency of correcting while holding a target.

208 cerebrospinal fluid samples were taken from patients having various patterns of neurological diseases. The following beta-globulins: transferrin, haemopexin, beta-1 A-globulin, beta-1 E-globulin, beta-2-glycoproteid and beta-lipoproteid were determined immunologically quantitatively in the CSF and partly quantitatively in the serum, and their behaviour was compared with that of the beta and tau fraction in CSF electrophoresis. It was found that changes in the fractions in CSF electrophoresis agreed only slightly with those of the quantitatively determined globulins, although these globulins represent 70--80% of the beta and tau fraction. Increases in the number of beta-1 A and beta-1 E-globulins are more significantly marked in intracranial haemorrhages than with other diseases. In all other respects, increases or decreases in the number of beta-globulins do not appear to be typical of any particular disease pattern determined by electrophoresis or quantitatively. Due to the linearity of the changes in case of disturbances of the CSF barrier, and also on account of the absolutely parallel behaviour of the beta-globulins, it was concluded that transferrin--contrary to the opinion held so far--is produced cerebrally in only small quantities or possibly not at all, and that the entirety of beta-globulins originate from the serum.