Lymphocytic adenohypophysitis of pregnancy with complete recovery.

A case of lymphocytic adenohypophysitis in a postpartum woman who became symptomatic during her 8th month of pregnancy is presented. The clinical presentation, endocrine findings, pathological findings, and operative management are discussed. Transient hypopituitarism is documented. Unlike most previously published cases, this woman had complete recovery of anterior pituitary function.

Multiple peripheral aneurysms of the posterior inferior cerebellar artery.

Peripheral aneurysms of the posterior inferior cerebellar artery (PICA) are rare. The authors describe a case in which five distinct peripheral aneurysms of the PICA were diagnosed and microsurgically clipped while preserving the parent vessel. One of the aneurysmal sacs was excised and examined pathologically, and no evidence of an infectious etiology was found. The surgical approach to peripheral PICA aneurysms is discussed and the literature concerning these unusual aneurysms is reviewed.

Aneurysm of the ICA petrous segment treated by balloon entrapment after EC-IC bypass. Case report.

A 44-year-old man experienced the sudden onset of horizontal diplopia and hemifacial numbness. Arteriography demonstrated a left intrapetrous carotid artery aneurysm. The patient was successfully treated with a left superficial temporal artery to middle cerebral artery bypass followed by balloon entrapment of the aneurysm. There have been at least 40 previously reported cases of aneurysms of the petrous portion of the carotid artery. These aneurysms can be mycotic, traumatic, or developmental in origin. They can present with massive otorrhagia or epistaxis from acute rupture or with decreased hearing and paresis of the fifth through eighth cranial nerves and, less frequently, of the ninth, 10th, and 12th cranial nerves caused by direct pressure. They can also produce pulsatile tinnitus, and sometimes they are discovered as a retrotympanic vascular mass during otological examination. The treatment of choice is carotid artery occlusion. Trapping of the aneurysm by detachable balloons eliminates immediately the risk of hemorrhage, offers the possibility of test occlusion of the internal carotid artery with the patient awake prior to permanent occlusion, and should also reduce the risk of thromboembolism. It should be preceded by a bypass procedure when preliminary evaluation indicates that the patient will not tolerate internal carotid artery occlusion.

Medulla oblongata edema associated with neurogenic pulmonary edema. Case report.

Neurogenic pulmonary edema (NPE) occurs in association with central nervous system disease without underlying cardiopulmonary problems. It is characterized by profound pulmonary vascular congestion and a fulminant clinical course. Although several reports document a role for experimental brain-stem lesions in the production of NPE, there have been only two studies in man correlating specific brain-stem lesions with NPE. The authors report a case of NPE occurring in a patient with von Hippel-Lindau disease and a dorsal medullary syrinx with postoperative dorsal medullary edema. The anatomical location of this patient's lesion is reviewed in the context of alternative theories of the pathogenesis of NPE.

Trigeminal afferents to cerebral arteries and forehead are not divergent axon collaterals in cat.

Horseradish peroxidase conjugated to wheat germ agglutinin (HRP-WGA), and bisbenzimide (a fluorescent dye) were used as retrograde axonal tracers to examine whether or not intracranial and extracranial trigeminal afferents represent divergent axon collaterals. HRP-WGA was applied to the proximal segment of the middle cerebral artery and bisbenzimide was injected into a branch of the ophthalmic nerve in 5 cats. Histologic examination of the ipsilateral trigeminal ganglion revealed HRP-labeled cell bodies located among clusters of cells exhibiting bisbenzimide fluorescence. Cells containing both labels were not observed. These results support the concept that divergent axon collaterals are probably not involved in the pathogenesis of referred pain during vascular headache.

Cervical diastematomyelia presenting in adulthood. Case report.

A case of cervical diastematomyelia in an adult is reported. The patient first noted sensory and motor symptoms at 34 years of age after two episodes of cervical trauma. Metrizamide computerized tomography myelography of the cervical spine and cord showed the region of diastematomyelia and revealed a spur containing both bone and fat tissue projecting into the spinal canal and cord. The spur arose from the laminae and spinous processes of C-2 and C-3, and was successfully excised. Postoperatively, the patient's deficits gradually improved. The literature concerning adult cervical diastematomyelia is reviewed.

Parasagittal organization of the olivocerebellar projection in the mouse.

The inferior olivocerebellar projection of the normal inbred C57BL/6J mouse was visualized after anterograde transport of horseradish peroxidase conjugated to the lectin wheat germ agglutinin (HRP-WGA conjugate). Following injections of HRP-WGA conjugate which filled the entire inferior olivary nucleus on one side, olivocerebellar fibers were followed across the midline of the medulla and into the contralateral cerebellar cortex via the inferior cerebellar peduncle. The molecular layer was heavily but nonuniformly labeled in all cortical lobules. Labeled olivocerebellar fibers within the contralateral cerebellar molecular layer were grouped into distinct bands separated by regions of molecular layer containing no labeled fibers. The bands of olivocerebellar terminals in the molecular layer were in turn organized into distinct sets of bands oriented in parasagittal planes. The organizational basis for this banding pattern, previously recognized by other workers in other mammalian and avian species, remains unknown.

Afferent projections to the central nucleus of the inferior colliculus in the rat.

The afferent projections to the inferior colliculus of the rat were studied using the method of retrograde transport of horseradish peroxidase (HRP). Following large injections of HRP into the central nucleus, cells within the cochlear nuclei, superior olivary complex and auditory cortex were stained. Within the contralateral dorsal cochlear nucleus, fusiform cells were heavily labeled. Giant cells were also labeled in deeper layers. In the contralateral ventral cochlear nucleus, virtually all major cell types were labeled, with some types being labeled in greater numbers than others. Octopus cells of posteroventral division of ventral cochlear nucleus (PVCN) were never labeled. HRP-positive cells were found in ipsilateral and contralateral lateral superior olivary nucleus (LSO), ipsilateral medial superior olivary nucleus (MSO), ipsilateral and contralateral lateral nucleus of the trapezoid body (LTB), ipsilateral ventral nucleus of the trapezoid body (VTB), and ipsilateral superior paraolivary nucleus (SPN). Pyramidal cells of layer V of auditory cortex were heavily labeled. Small injections of HRP into the central nucleus resulted in labeled cells within restricted regions of the cochlear nuclei, superior olivary complex and auditory cortex. Injections into dorsal regions of the central nucleus resulted in cells labeled in ventral regions of the dorsal and ventral cochlear nuclei, and in lateral regions of LSO. These regions contain neurons which are considered to have low best frequencies. Injections placed in more ventral regions of the central nucleus led to labeling of cells in more dorsal regions of the cochlear nuclei and more medial regions of LSO in agreement with the tonotopical progressions within these structures.