S. Mingrino

Histological and ultrastructural study of intracranial saccular aneurysmal wall

SummaryThe material studied consists of 10 cases of intracranial saccular aneurysms. Four came from autopsies, and in each of the other six aneurysmal wall was obtained at surgery after clipping of the aneurysm. The most significant findings from this pathological study are the almost complete disappearance of the internal elastic lamina at the level of the aneurysmal neck, sclerosis of the muscle coat, and in satellite vessels and vasa vasorum disruption of the internal elastic lamina and partial luminal occlusion. The importance of ischaemic changes in the aneurysmal wall is discussed. Rupture of the aneurysm at the distal extremity of the sac depends probably on the progressive brittleness of its wall which becomes sclerotic and less resistant to the blood pressure within. Splitting or rupture of the aneurysm appears to be dependent on degenerative ischaemic alterations in its wall.

Posttraumatic intraventricular haemorrhages

SummaryOf a series of 350 patients studied for blunt head trauma by CT scan 10 were found to have an intraventricular haemorrhage (IVH); in 8 cases we could find concomitant CT abnormalities as well as intracerebral contusion or haemorrhage, and in two cases no other CT abnormality was noted.CT scan represents the first reliable and non-surgical tool for identifying this process.Two possible mechanisms that govern the formation of an IVH are postulated: a) an erosion of the ventricular wall by an intracerebral haemorrhage; b) the rupture of subependymal veins deformed by the negative pressure following dilatation of the ventricular wall.The prognosis in our cases is severe.

Malignant astrocytoma associated with arteriovenous malformation

SummaryThe coincidence of vascular malformation and primary brain neoplasm is very rare.A prevalently venous malformation associated with a malignant astrocytoma of the left temporal lobe is reported, and the pathological features are discussed.

Pituitary adenomas secreting more than two hormones

SummaryA case of pituitary adenoma secreting more than two hormones is presented. Morphological findings of this tumor have been correlated with biological behavior and with hormonal activity.

Enlargement of intracranial saccular aneurysms. A case report.

SummaryA case of enlargement of a middle cerebral artery aneurysm is reported. Cerebral angiography demonstrated an increase in the size of this aneurysm. Possible factors causing aneurysmal enlargement are discussed.

Scanning electron microscopy (s.e.m.) of biopsy specimens of ruptured intracranial saccular aneurysms.

SummarySurgical specimens of 4 intracranial saccular aneurysms were studied by scanning electron microscopy. The internal surface of the aneurysms showed crater-like defects and cytoplasmic bridges. In some areas the endothelium was preserved, but its longitudinal convolutions were higher and thicker than those found in unchanged areas. On the damaged endothelial surface there was an increased number of blood cells. The adventitia resembled that of a normal cerebral artery. In conclusion the alterations observed are similar to those found in atherosclerosis and are most likely dut to the high wear and tear provoked by the blood streaming into the aneurysm. The results of this study are in agreement with the findings of a companion transmission electron microscopy study and emphasize the importance of degenerative changes on the development and rupture of intracranial saccular aneurysms.

Selective angiography of the external carotid artery and its branches by catheterization of the superficial temporal artery

SummaryA technique for selective angiography of the external carotid artery and its branches by means of proximal and distal catheterization of the superficial temporal artery has been described.The results obtained by this method in 32 angiograms have been summarized and representative cases have been presented in detail.The advantages of this technique and its indications have been discussed.Selective angiography of the external carotid artery by catheterization of the superficial temporal artery is indicated:1.When the technique of selective catheterization of the external carotid artery through the common carotid artery has failed.2.In cases where selective visualization of particular areas within the external carotid artery distribution is needed.

Fine Structure of Prolactin Pituitary Adenoma with Special Reference to Annulate Lamellae

SummaryElectron microscopy revealed the presence of annulate lamellae in the cytoplasm of a heavily granulated prolactin cell adenoma that had been removed from a 34-year-old male patient presenting impotence.To our knowledge this is the third case of pituitary adenomas where annulate lamellae are reported.