[Case of selective lesion of the pyramidal tract at the brain stem level of vascular origin].
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Biomedical subjects
Publications and source records attributed to J Rafalowska.
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Convulsions, extrapyramidal-cerebellar syndrome and coma led within 8 weeks to death of a 40-year-old woman. Autopsy demonstrated calcifications in the ganglia of brain base and cerebellum.
The levels of oxyhaemoglobin and bilirubin were determined in the cerebrospinal fluid in 46 cases of subarachnoideal haemorrhage and cerebromeningeal haemorrhage, 18 cases of haemorrhagic infarction. Autopsy confirmation was available in 18 cases of haemorrhages and 18 cases of infarction. Determination of oxyhaemoglobin and bilirubin levels in the cerebrospinal fluid is not sufficient as a reliable basis for differentiating between cerebral haemorrhage and haemorrhagic infarction. High values of oxyhaemoglobin and bilirubin seem to indicate bleeding into the cerebrospinal fluid spaces. Assessment of oxyhaemoglobin level and cerebrospinal fluid sediment suggests in some cases the diagnosis.
Maximal motor conduction velocity of ulnar nerve was measured in 7 patients 80-93 years old, who suffered from cerebro-vascular stroke. In 2 cases motor conduction velocity was significantly decreased. Specimens for histopathological study were taken from the spinal cord at the C8 and Th1 segments and from the ulnar nerve at the elbow level on the side opposite to the hemiparesis. In 100 sections of each senile case and in 3 control cases of younger individuals the motoneurons of the retro-postero-lateral nucleus with visible nucleoli were counted. In the ulnar nerve qualitative and quantitative examinations were performed. The study showed a significant loss of motoneurons in the nucleus and a loss of myelinated fibers especially the thickest ones in the ulnar nerve in elderly cases. In teased preparations axonal degeneration and segmental demyelination of some fibers were seen. Morphological changes in some cases, resulted in a slowed down motor conduction velocity.