Neuropathological diagnosis with stereotactic biopsies: Possibilities, difficulties and requirements

The present paper is based on stereotactic biopsies (SB) of 870 patients during the last 20 years. Approximately 700 patients suffered with brain tumour. Dementias and various diseases such as vasculopathies, leucoencephalopathies and inflammatory lesions were diagnosed in the other cases. Three groups of problems can be diagnosed with SB: 1) deeply located brain lesions; 2) early stages of lesions and diffuse or multiple lesions detected with imaging techniques; 3) some progressive dementing or degenerative diseases. Multiple (generally 4 to 6) SB should be taken in the vicinity and various parts of the lesion; they should be numbered, described separately and located exactly on an image of the brain. Handling the SB with care and the quality of the processing are important. Previous contact between neurosurgeon and neuropathologist can improve the accuracy of the diagnosis, which is reliable in the majority of cases, without producing undesirable brain damage

Hemodynamic activity associated with paraganglioma of the cauda equina [7]

SCOPUS: le.jinfo:eu-repo/semantics/publishe

Lacunar infarctions due to cholesterol emboli

BACKGROUND AND PURPOSE: Hypertension is commonly considered the major cause of lacunar infarctions. However, in some cases, it has been suggested that lacunes could be caused by cerebral emboli from cardiac or carotid sources. Cholesterol cerebral emboli have been rarely reported as a cause of lacunes. CASE DESCRIPTION: We describe a 79-year-old patient with a progressive multi-infarct dementia who developed transient motor aphasia and paresis of the right arm. Computed tomography showed lacunar infarcts in the right caudate nucleus, left thalamus, and left putamen, as well as an old right frontal infarction. Neuropathological examination demonstrated no prominent vascular hyalinosis, but did show multiple cholesterol emboli occluding small arteries around lacunar infarcts and leptomeningeal arteries near cortical infarcts. The cholesterol material presumably originated in the extended atheromatous changes along the aortic arch. CONCLUSIONS: Our report confirms that lacunes can be caused by cholesterol emboli in some patients. Small cerebral emboli should not be overlooked as a cause of lacunes