George P. Sayre

Relationship of degree of atherosclerosis of internal carotid system in the brain of women to age and coronary atherosclerosis.

Cerebral infaretion currently is the third leading cause of death in the United States. Since atherosclerosis of the cerebral arteries is the basis for the majority of strokes, the authors undertook to define more accurately the distribution of such atherosclerosis, its relation to coronary atherosclerosis, and its relation to such other factors as hypertension, obesity, and cerebral infarction. The results of their study are presented here.

Hereditary amyotrophic lateral sclerosis: A clinical and pathologic report with comments on olassification

AMYOTROPHIC LATERAL SCLEROSIS (motor system disease) has been described as a disease of unknown etiology, sporadic occurrence, and short duration. Recently, the occurrence of a hereditary form of this disease has been reemphasized. Stressed by some authors is the identity of clinical symptoms in patients with sporadic and familial amyotrophic lateral sclerosis.’ This has been adduced as evidence that this disease has one etiology, that is, heredity. Furthermore, it has been stated that there is no characteristic family form (“il n’existe pas de type familial, c’est-&-dire daspect clinique ou 6volutif propre a charjue famille et caracteristique de celle-ci”) 2 While this may be true when each member of the family is considered individually, it appears that clinical or pathologic characteristics are often peculiar to families with hereditary amyotrophic lateral sclerosis.Lu In our opinion, the family we are presenting also demonstrates such peculiarities. These characterize the clinical expression of amyotrophic lateral sclerosis in the affected members and merentiate the familial or hereditary type from that seen in the sporadic form of the disease. Three members of this family have been seen at the Mayo Clinic. We examined two siblings here recently, and Dr. F. P. Moersch had examined one in 1951. In addition, we had the opportunity to review the postmortem material on a fourth sibling.

Effect of Anticoagulants on Experimental Cerebral Infarction: Clinical Implications

Cerebral infarction is attended by extravasation of blood in varying degrees. The present study was undertaken to learn whether anticoagulant therapy increases the extravasation and thereby diminishes or negates possibly favorable therapeutic effects. A series of experiments on dogs is described and the clinical implications are discussed.

Neurovascular Complications of Dialysis and Transplantation

Dialysis and transplantation are now standard treatments for end-stage renal failure. Often, neurologists are consulted regarding the neurological complications of these therapeutic procedures. In addition to previously reported complications, neurovascular disease is being recognized as a cause of mortality and morbidity in these patients. We report two cases of apparent thromboembolic stroke in young patients with renal failure — one treated by dialysis and the other by renal transplantation. The risk factors of both dialysis and transplant are identified and data from the American College of Surgeons/National Institutes of Health Transplant Registry are reviewed.

Tumor Embolism of the Basilar Artery: Case Report

Massive fragmentation of a neoplasm with embolic spread to the brain causing vascular obstruction and infarction is a rarely reported phenomenon. The most frequent site of such obstruction in the cerebral circulation is in the middle cerebral artery or one of its branches. Only one reported case1of neoplastic occlusion of the basilar artery by embolism was found in the world literature. Recently we observed a second case; because of the rarity of this condition, we wish to report it and to review the pertinent literature. Report of Case A 64-year-old housewife was referred to the Mayo Clinic on April 19, 1960, for evaluation of a mass in the lung, and for hemoptysis. The patient gave a history of having had intermittent cough with blood-streaked sputum for 6 months and of general malaise and anorexia with loss of 10 pounds in the last 2 months. She denied smoking cigarettes.

Experimental Allergic Encephalomyelitis Following Administration of Homologous Brain Lipid Fractions

SINCE 1933 when Rivers, Sprunt, and Berry’ first produced an encephalomyelitic condition in monkeys by injection of brain emulsion and an alcoholic brain extract, many attempts have been made to isolate and identify the substance in brain responsible for the lesions of the central nervous system. Various substances have been considered to be responsible for the encephalomyelitis, including lipids such as the phosphatides, lecithins, cephalins, and the cerebrosides, as well as lipid-free protein substances. Although it is generally agreed that a lipid-soluble material is involved, there has been wide divergence in results reported from different laboratories. For instance, Alvord2v3 reported activity of an acetone-soluble fraction, whereas Kabat, Wolf, and Bezer405 were unable to demonstrate activity of an acetone extract of brain. Ferraro, Roizin, and CazzulloS observed slight activity of acetoneether and ether extracts, while Olitsky and Yager’ reported that an acetoneether soluble fraction had no encephalitogenic potency. Koprowski and Jervisx reported that a methanol-chloroform extract of brain which they believed contained cerebrosides and sphingomyelin was capable of producing encephalomyelitis in experimental animals. There are also reports of nonlipid preparations of brain having encephalitogenic activity. Bell, Wright, and Habelg demonstrated activity of a calcium acetate solution of brain after lyophilizing the brain and defatting it by extraction with benzene and ether. Ferraro and Roizinlo also reported that a calcium acetate solution of defatted brain was active. Their procedure differed from Bell’s in that acetone treatment of wet brain was used in place of the lyophilizer for drying the brain. Presumably the active “antigen” was a protein, soluble in the calcium acetate solution. Furthermore, Hottle, Nedzel, Wright, and Bell” demonstrated encephalitogenic activity of a water dialysate of lyophilized brain which had been defatted by extraction with benzene and ether, where-