[Sciatica due to chronic spontaneous lumbar epidural haematoma. Report of a case simulating a protruded disk syndrome (author's transl)]

A case of spontaneous chronic lumbar epidural hematoma, in a 70-year-old woman is reported. The clinical, roentgenographic and anatomic findings of this case and of six others found in the available literature are studied. This clinical entity occurs in elderly and must be considered in the differential diagnosis of protruded disk syndromes.

Neuropsychological testing during a transient global amnesia episode and its follow-up

A case of transient global amnesia has been neuropsychologically assessed during the attack. Global involvement of any memory modalities and far-reaching retrograde amnesia were found. Follow-up retesting, 1 week and 6 months later, showed persistence of mild verbal memory impairment.

Clinical observations on 76 cluster headache cases

76 cases of cluster headache are reviewed. Besides confirming established notions, the present study calls attention to the following points: (a) the peculiar behaviour of patients during the attacks does not appear explainable in simple terms of reaction to pain; (b) the occurrence of ECG abnormalities during the attacks in addition to bradycardia; (c) the well-known tendency of cluster headache attacks to recur at the same time of day, has in our cases a very high peak at 3 p.m., and (d) when the attacks occur in sleep hours, the time relationship with REM sleep stage is confirmed in our cases which have been recorded at night.

[Transitory ischemic attacks, migraine and progestogen drugs. Etiopathogenetic correlations]

Two cases of transitory ischaemic attacks, which occurred during progestogen therapy, are reported. Clinical history and symptoms of both patients suggested migraine disorder. Therefore, the hypothesis is made that also progestogen-only preparations, likewise oestrogen-progestogen oral contraceptives, may cause neurological troubles by vasomotor mechanisms.

[Bilharzial myelopathies (case report) (author's transl)]

Report of a case of biharzial myelitis appearing 6/8 weeks after bathing in an infected river. Recovery was complete after medical treatment with niridazol and hycanthone. The authors review the 47 detailed cases previously reported, selected among 60 cases observed from 1905 to 1963. They consider the clinical and pathological aspects and discuss the various pathogenic problems. Treatment requires specific antibilharzial compounds and anti-inflammatory drugs and, in compressive forms, sometimes surgery.

[Plasma cells leukaemia, cryoglobulins and antithrombin (author's transl)]

Although primitive plasma cells leukaemia is uncommon, it still stands in a particular place among malignant lymphoplasmocytary syndroms. It borrows from multiple myeloma and acute leukaemia some of its clinical and biological manifestations. Its course is quickly adverse, its treatment ineffective and the average life expectation is three months.

Neuropsychological functions in the follow-up of transient global amnesia

Sixteen patients, who had suffered only one episode of transient global amnesia and showed no clinically evident abnormalities in their follow-up, were examined with psychometric and memory tests. Deficits in verbal long-term memory and in verbal IQ were found. These observations seem to demonstrate that in transient global amnesia patients regarded as being 'normal' in their follow-up there is no complete recovery and the sequelae seem to conform to a definite pattern. Problems of nosology and localization are discussed.

[Adrenal cortical adenoma and arterial hypertension. Adrenal vizualisation by scintillation with 131 I 19 iodo cholesterol (author's transl)]

A case of adrenal cortical adenoma and arterial hypertension is reported. We emphasize interest of scintillation scanning with 131 I 19 iodo cholesterol, worth of routine examination when seeking for these tumors.

[Total atrophy of the villi during primary agammaglobulinemia in adults. Therapeutic problems (author's transl)]

A 21-year-old man presented with a 10-year history of a malabsorption syndrome of moderate severity, splenomegaly, and recurrent respiratory infections. Investigations revealed total atrophy of the villi and primary agammaglobulinemia. A gluten-free diet was ineffective. In spite of the absence of lambliasis, treatment with metronidazole produced objective clinical improvement and biological signs of healing of the malabsorption syndrome, but no alteration in the agammaglobulinemia. The authors discuss the relationship between total villous atrophy and primary agammaglobulinemias and the mode of action of metronidazole.

[Case studies of left unilateral apraxia]

The authors report two cases of motor apraxia, agraphia and tactile anomia on the left side, associated with bilateral constructive apraxia. These cases are discussed in relation to their unusual etiology and in relation to possible pathogenetic hypothesis other than classical Liepmann's scheme.

Analysis of natural corticosteroids in adrenal extracts and in biological fluids by high-performance liquid chromatography

A liquid chromatographic procedure is described for the analysis of the principal natural corticosteroids in extracts of adrenal glands. Microparticulate silicic acid columns and gradients of methanol in chloroform are used: conditions are described for the quantitative analysis of the single principal steroidal components of adrenal extracts for pharmaceutical use and of adrenal extracts of rats. In the last case, the use of a 5-micron silica column with the appropriate gradient allows the determination of corticosterone and of 18-hydroxydeoxycorticosterone, which were identified by means of mass spectrometry on their eluates. A single analysis can be performed on the extract of 15 mg of rat adrenal tissue. For the last type of analysis, isocratic conditions on a 10-micron LiChrosorb Diol column are also described. The application of the gradient elution procedure to the analysis of steroidal compounds in human plasma is also described.

[Renal lesions in progressive systemic sclerosis. A report on five cases (author's transl)]

Renal lesions are one of the must serious visceral complications of progressive systemic sclerosis: three of the five cases reported died in anuria within a few weeks. A part from this very severe fulminating form, however, cases in which lesions can be demonstrated by pathological examination may produce much milder clinical and biological signs, though still having the same prognostic significance. They can become worse at any moment, either spontaneously, or more often because of other factors such as corticotherapy or pregnancy. A review of the published literature has shown the exact frequency of these lesions and their two principal modes of progression, in both of which the same basic histological changes of proliferation of the intima of the interlobular and preglomerular arteries are found. Kidney function tests can be used to guage the severity and extent of these vascular lesions. It is much more difficult, however, to determine the nature of the initial mechanism causing these lesions. The vascular lesion could be a primary one or may be secondary to an immunological disorder, the exact nature of which has still to be determined.

Testosterone metabolism in basal cell epitheliomas

In basal cell epitheliomas the testosterone metabolism pattern differs from that of the normal surrounding skin. There is a significant reduction in 5 alpha-reductase activity with a consequent decrease in production of dihydrotestosterone and androstanediols. By contrast the 17 beta-hydroxysteroid dehydrogenase activity shows no consistent change.