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Biomedical subjects

F Gray

Publications and source records attributed to F Gray.

At least 217 records · Page 12Linked to original sources
PubMed1985

Fatal nonmeningitic Listeria rhombencephalitis. Report of two cases.

Two cases of rapidly fatal Listeria rhombencephalitis with normal cerebrospinal fluid (CSF) findings occurred in previously healthy adults. The infection presented with nausea and headache followed by fever and signs of lower cranial nerve dysfunction, without associated meningismus, and progressed to death within four and six days of hospitalization. Because of normal CSF findings (including ventricular fluid in one patient) and negative culture results of both blood and CSF, the diagnosis was not suspected. Listeriosis should be considered early in any febrile patient presenting with signs of brain-stem dysfunction, even if CSF findings are normal.

Adult↗
PubMed1985

[Cavitary orthochromatic leukodystrophy with oligodendroglial changes. A sporadic adult case].

A 39 year-old man with mild stable mental retardation, without family history, developed progressively a gait disturbance and intellectual deterioration. CT scan showed a low density of the periventricular hemispheric white matter which increased on subsequent examinations. Eight months before death he presented with several Grand Mal seizures. He died 29 months after the onset of the clinical disorders. Neuropathological studies included light and electron microscopy of a cerebral biopsy and a post-mortem examination of the brain. It showed a sudanophilic leukodystrophy with unusual features: cavitation of the white matter, oligodendrocyte proliferation and lamellar "fingerprint" dense cytoplasmic inclusions in the oligodendrocytes. Only 3 similar cases have been previously reported.

Adult↗
PubMed1985

[Cerebral lymphoma associated with lesions of multiple sclerosis].

A 24 year-old man experienced a left retrobulbar neuritis which improved completely after 2 months of non-steroid antiinflammatory therapy. One month after the end of the treatment he developed a Korsakoff-like amnestic syndrome. Three months later he complained of horizontal diplopia. A CT Scan showed a diffuse enhancement of the periventricular areas, corpus callosum and fornix. Diplopia and CT scan abnormalities disappeared after the administration of tetracosactide. Subsequently a progressive worsening of the neurological condition developed, including a 1 1/2 syndrome of Fisher. In C.S.F. proteins ranged from 35 to 66 mg/dl, gammaglobulins from 4 to 5 per cent, cells from 2.2 to 6.8 per mm3 without abnormal cells. Rounded areas of enhancement were observed on CT scan in pons and right occipital lobe. Usual biological tests, abdominal echography and lymphography were normal. Death occurred 15 months after the onset of symptoms. Neuropathological examination showed: 1) a cerebral lymphoma of probable B origin with distinct masses in right occipital lobe and pontine tegmentum and a more diffuse perivascular infiltration on the left side in the amygdaloid nucleus, fourth temporal gyrus, sublenticular area, hypothalamus and in the right internal capsule; 2) multiple small clear-cut foci of demyelination with myelin-axonal dissociation bilaterally in the optic pathways, periventricular regions, corona radiata, cerebral and cerebellar white matter, sublenticular areas, temporal lobes, splenium of the corpus callosum and fornices with secondary atrophy of the mamillary bodies. Both recent and old plaques were observed. Inflammatory perivascular cuffing, when present, consisted of small nontumoral lymphocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Computed tomography in primary lymphoma of the brain.

C.T. scans of 19 patients with histologically proved primary lymphoma of the brain were reviewed and divided into three groups: solitary tumors (58%), multifocal tumors (31,5%), diffuse involvement of the brain (10,5%). The C.T. differential diagnosis are manifold, including meningioma, glioma, metastases, progressive multifocal leukoencephalopathy. Arteriography is not specific, but, correlation with C.T. results may suggest the correct diagnosis and encourage biopsy. The radiosensitivity of primary lymphoma of the brain emphasizes, the importance of an early diagnosis.

Adult↗
PubMed1984

Dementia in idiopathic Parkinson's disease. A neuropathological study of 32 cases.

Neuronal loss was estimated semiquantitatively in the substantia nigra (SN) and locus coeruleus (LC), and by cell counts in the nucleus basalis of Meynert (NBM), in 32 patients with idiopathic Parkinson's disease (14 non-demented and 18 demented). The number of senile plaques (SP) and neurofibrillary tangles (NFT) was rated in four cortical areas. Neuronal loss in the SN seemed in dependent of mental impairment, while severe lesions of the LC were more frequent in demented patients. In the NBM, neuronal loss and Lewy bodies were observed in most cases (95%) and were associated with significant reductions of choline acetyltransferase (CAT) activity both in the NBM and the cortex (measurements available for 13 cases). This confirms that the cholinergic innominato-cortical pathway is damaged in Parkinson's disease and that the lesion is severer in subjects with dementia. SP and NFT were present in the cortex in 75% of the cases and significantly more numerous in demented patients. However, in 37% of the cases (six cases with dementia), the score for cortical changes was low and could be related to age. Cortical SP and NFT were not correlated to the degree of cell loss in LC and NBM, or to CAT activity in the cortex or NBM. Damage to coeruleo-cortical, innominato-cortical and intra-cortical neurones could each play a role in the appearance of dementia in Parkinsonism. The lesions in the different neuronal systems do not seem to evolve in parallel, but may be additive or potentiate one another in terms of functional expression. Also, the variety in extent and degree of lesions encountered in Parkinson's disease may offer a pathological substrate for the wide variety of mental symptoms described in this illness.

Acetylcholine↗
PubMed1984

Adult form of Leigh's disease: a clinico pathological case with CT scan examination.

The clinical and pathological findings of a 31-year-old woman, in whom the diagnosis of Leigh's disease was made, are reported. CT scan examination with contrast enhancement showed symmetrical areas of low density, in both thalami, anterior limbs of internal capsules and corpus callosum. Longstanding chronic lesions involved the optic chiasma and the cerebral peduncles and consisted of myelin loss, status spongiosus, astrocytic gliosis and marked capillary proliferation. The neurons were spared. In the basal ganglia, internal capsules and corpus callosum, these lesions were more recent and consisted of focal necrosis, perivascular oedema and few lymphocytic perivascular cuffings.

Adult↗
PubMed1984

[Cavitary orthochromatic leukodystrophy in the adult. Oligodendroglial proliferation and inclusions].

A 41 year-old woman presented with two Grand Mal fits followed by progressive spastic paraparesis and intellectual impairment. After 18 months there was a remission which lasted for 4 years but thereafter inexorable progression of the disease and many fits led to a state of akinetic mutism. Death occurred nine and a half years after the onset of the illness. There was no family history. The neuropathological studies included light and electron microscopy of a cerebral biopsy and a complete post mortem examination. Myelin loss and cavitation of the white matter was associated with the presence of sudanophilic lipid and abundant cells at the periphery of the lesions. These cells had the characteristics of oligodendrocytes. The combination of sudanophilic leucodystrophy, cavitation of white matter and oligodendrocyte proliferation has previously been observed only in childhood.

Adult↗
PubMed1984

[Baló's concentric sclerosis].

A clinico-pathological case of concentric sclerosis (Baló type) is reported. A 30-year-old man experienced dizziness, nausea and vomiting. Twelve days later he developed gait disturbances. Neurological examination showed broad based gait, brisk tendon reflexes, bilateral extensor plantar responses, right hemihypoesthesia, cerebellar dysmetria, and a left lateral gaze palsy. CSF examination showed, 520 mg p. 100 ml protein, 7500 red blood cells, 31 lymphocytes and 9 polymorphonuclear leukocytes/mm3, 18 p. 100 gammaglobulin. Three CT scans were performed and showed a round hypodensity in the parieto-occipital white matter with contrast enhancement on one occasion, and several other hypodensities in the contralateral parieto-occipital white matter and in both frontal lobes. 23 days after the onset of the disease, the patient became comatose. A cerebral biopsy was obtained from one of the frontal lesions. He died from aspiration bronchopneumonia 2 months after the first signs. Neuropathological examination showed numerous concentric zones of demyelination which involved the white matter of both hemispheres, brain stem, and cerebellum. On light microscopy sudanophilic myelin breakdown products were numerous in the bands of demyelinisation. Astrocytic proliferation was marked, with frequent Rosenthal fibers. Edema was noted in some lesions. Myelin-axonal dissociation was obvious, but some axonal swelling were observed. Electron microscopy demonstrated the integrity of oligodendrocytes and of blood vessels and confirmed the prominent alterations of the astrocytes. Fifteen similar cases of the literature have been reviewed. The present case seems to be the first one with CT scan examination and electron microscopic study of a brain biopsy. The nosological situation of Baló's disease among the inflammatory demyelinating diseases of the group of MS is discussed.

Adult↗
PubMed1983

[Whipple's disease with encephalopathy. A case report with review of the literature].

A 58 year-old man developed a progressive encephalopathy four years after Whipple's disease onset with digestive, lymph node, and multiple joint lesions, treated over a period of two years. The diagnosis of neurological manifestations of Whipple's disease was based on clinical findings and the presence of PAS+ inclusion bodies in CSF cells. The outcome was fatal in spite of antibiotic therapy. Diagnostic features of this rare neurological affection are discussed. Preventive treatment and surveillance of patients with Whipple's disease are necessary even after well-conducted therapy.

Anti-Bacterial Agents↗
PubMed1983

[Acquired cerebral toxoplasmosis in adults. Clinical and neuropathologic study].

Two cases of acquired cerebral toxoplasmosis in adults are reported. In the first case no subjacent disease was found, and the neurological signs were of a meningo-encephalitic type with disorders of consciousness and a C.S.F. cellular reaction. A second case was observed in the course of the treatment of Waldenström disease by chloraminophene. The neurological signs were bifocal, and the C.S.F. showed a moderate increase of protein. In both cases C.T. scan showed contrast enhanced and hypodense areas. In the first case the enhancement was heterogenous and the hypodense area occupied the whole right hemisphere. The second case showed two ring enhancements in the left frontal and the right occipital regions. A cerebral biopsy was performed in both cases but no parasite was found. The diagnosis was presumed to be malignant lymphoma or encephalitis in the first case, glioblastoma in the second. No specific treatment was administered and the patients died within a few weeks. The complete pathological study by light and electron microscopy showed free and cystic forms of Toxoplasma Gondii. The results of the neuropathological examination and the thorough study of the biopsy specimens were compared to the pathological findings in the literature. The particular character of the necrosis and the inflammatory encephalitic reaction in the absence of the parasite may suggest the diagnosis when the clinical, biological and radiological data are compared.

Aged↗
PubMed1983

[Steele-Richardson-Olszewski disease without ophthalmoplegia. 6 clinico-anatomic cases].

Six clinico-pathological cases (4 males and 2 females) with a Parkinson-like syndrome which lasted an average of 5 1/2 years are reported. The average age at death was 73 years. Neuropathological features were similar to those described in post encephalitic Parkinson's syndrome and in Steele-Richardson-Olszewski disease. However, neurofibrillary tangles were less numerous; lesions in tectal, periaqueductal and reticular structures were less severe. Furthermore, the lesions seemed more pronounced in the substantia nigra, the globus pallidus and the nucleus subthalamicus, giving the appearance of a systematic pallido-luyso-nigral atrophy. None of these patients had a history of encephalitis. Clinical examination did not reveal the dystonic rigidity in extension of the neck nor the characteristic ophthalmoplegia of progressive supranuclear palsy. These 6 cases are compared to 10 cases of progressive supranuclear palsy typical both on clinical and pathological grounds. They could be considered as a particular form of Steele-Richardson-Olszewski disease without ophthalmoplegia.

Aged↗