Balloon migration into a giant carotid aneurysm after parent artery occlusion using detachable balloons.

SUMMARY: We treated a 70-year-old man with a giant paraophthalmic region aneurysm of the right internal carotid artery using the parent artery occlusion technique with three detachable balloons. Initially, the patient did well, but migration of the distal balloon into the aneurysm was detected seven months later. This report suggests that initial parent artery occlusion using balloons will not always induce permanent thrombosis of a large aneurysm, because the occlusion and thrombosis is strictly dependant on the position of the balloons that are used, and adjunct use of coils may be indicated.

Motor neuron disease and angiotropic lymphoma.

BACKGROUND: The number of patients with motor neuron disease (MND) and a concomitant hematologic disorder appears to be overrepresented. Angiotropic large cell lymphoma, a rare and aggressive type of lymphoma, has been associated with MND only once (to our knowledge) prior to this report. There are more than 35 cases of MND associated with lymphoma or monoclonal gammopathy reported in the literature. The nature of this association remains disputable. OBJECTIVE: To investigate whether the association between some MNDs and certain hematologic disorders is coincidental or pathogenetically related. CASE PRESENTATION: We describe the clinical and neuropathologic findings in a case involving a 70-year-old man with a rapidly progressive lower MND who at autopsy also exhibited angiotropic large cell lymphoma without ischemic lesions in the nervous system. CONCLUSIONS: This case supports the notion that the association between some MNDs and certain hematologic disorders is not coincidental but pathogenetically related. A 2-hit hypothesis is proposed in which an initial abnormal glycosylation in motoneurons would require the production of an appropriate autoantibody for disease expression.