Subject(s)
Autopsy/methods , Adult , Child , Diagnosis, Differential , Female , Forecasting , Humans , MaleABSTRACT
Prompt and accurate diagnosis of viral encephalitis has acquired increased significance because of the encouraging results obtained in therapeutic trials with antiviral agents such as adenine arabinoside. Currently, brain biopsy remains the only reliable method to confirm the diagnosis of viral encephalitis. This communication, based on the analysis of eighteen confirmed cases of viral encephalitis, illustrates structural abnormalities common to these conditions and suggests biopsy handling procedures that appear most helpful in arriving at a prompt diagnosis. In addition to the traditionally well-known inflammatory changes, such as satellitosis, gliosis, and neuronophagia, a variety of intranuclear inclusion bodies are illustrated, and the judicious application of immunocytochemistry and electronmicroscopy is emphasized.
Subject(s)
Brain/pathology , Encephalitis/pathology , Adolescent , Adult , Aged , Biopsy , Brain/microbiology , Child , Child, Preschool , Encephalitis/microbiology , Female , Humans , Immunoenzyme Techniques , Inclusion Bodies, Viral/ultrastructure , Male , Middle AgedABSTRACT
Unilateral microembolization of the cat brain with carbonized microspheres 15 microns in diameter ten minutes (min) before death induced multifocal disruption of the blood-brain barrier (BBB) to horseradish peroxidase (HRP) in nine adult cats. The gross pattern of HRP extravasates was studied: (a) after five min of in vivo circulation, (b) following infusion of HRP immediately before chemical fixation, and (c) following infusion of HRP after 60 min of aldehyde fixation. Examination of the material from the three different experimental groups revealed no qualitative differences at the light microscopic level; specific features such as ring-shaped extravasations of HRP occurred irrespective of the mode of tracer injection. Tracer-filled pinocytotic vesicles and tubular profiles were abundant in the vascular endothelium after in vivo circulation of HRP, but were virtually absent after supravital and postmortem HRP administration. The results suggest that BBB breakdown for proteins after microembolization is not an energy-dependent process mediated by either pinocytosis or tubular-endothelial channel formation.
Subject(s)
Blood-Brain Barrier , Capillary Permeability , Intracranial Embolism and Thrombosis/physiopathology , Animals , Brain/ultrastructure , Cats , Endothelium , Female , Horseradish Peroxidase , Intracranial Embolism and Thrombosis/metabolism , Intracranial Embolism and Thrombosis/pathology , MaleSubject(s)
Creutzfeldt-Jakob Syndrome/drug therapy , Vidarabine/therapeutic use , Female , Humans , Middle AgedABSTRACT
An 11-year-old black boy complained of intermittent occipital headaches with nausea and projectile vomiting. Previous skin and lung biopsy specimens were interpreted as histiocytosis X. Cranial computed tomographic scanning disclosed a mass lesion in the region of the choroid plexus of the left lateral ventricle. This was surgically removed but proved nondiagnostic despite extensive histologic examination. An ophthalmologic evaluation showed discrete, elevated, yellow-white choroidal tumors in both maculas. The ophthalmoscopic appearance, as well as ultrasonography and computed tomography, led to the diagnosis of choroidal osteomas.
