Skull malformation and cerebellar herniation in captive African lions

Thickening of the cranial vault with a resulting cerebellar herniation is described in a series of litters of lion cubs, all with the same parents, one of whom was also very mildly affected. This animal, when mated to his daughter, also produced affected cubs. The aetiology of the condition is discussed and it is considered that vitamin A deficiency may have been less important than has been suggested by other authors.     

Adult Arnold-Chiari malformation: a postpartum case presentation

Adult Arnold-Chiari malformation, also known as Chiari malformation type I, typically occurs in women during early adulthood and can be a cause of unexplained headaches, as well as associated syringomyelocele. In this unique case report, a 32-year-old, postpartum woman with posturally induced headache from Chiari malformation type I had symptoms occur for the first time during pregnancy. Magnetic resonance imaging of the brain confirmed the diagnosis and is the neuroimaging study of choice in such cases. Neurosurgical decompression, when performed early, is highly successful in symptomatic individuals.     

Spontaneous intracranial hypotension: headache with a reversible Arnold-Chiari malformation

Spontaneous intracranial hypotension is characterized by severe postural headache in the setting of low CSF pressure, usually attributed to a cryptic CSF leak. We report a patient whose prolonged refractory headache was characterized by the clinical symptoms of occipital neuralgia, but was also associated with the radiographic appearance of an Arnold-Chiari malformation, type I and low CSF pressure. After extensive diagnostic evaluation, CT cisternomyelography ultimately demonstrated a CSF leak at the C2 vertebral level. Symptomatic relief was sustained only with long-term theophylline administration. The apparent Arnold-Chiari malformation resolved with treatment of the low CSF pressure.     

Central sleep apnoea in Arnold-Chiari malformation: evidence of pathophysiological heterogeneity

We report on the case of two young patients with type I Arnold-Chiari malformation (ACM), as revealed by a central sleep apnoea (CSA) syndrome without any other neurological defect. Case 1 was a 14-yr-old male patient, who developed severe alveolar hypoventilation and needed long-term mechanical ventilation via a tracheostomy. Case 2 was a 39-yr-old male patient, who developed features suggestive of sleep apnoea and responded to nasal continuous positive airway pressure ventilation despite the central type of apnoeas. These two cases illustrate the different pathophysiological mechanisms involved in CSA, namely a blunted chemical drive (in hypercapnic patients) and an increased chemical drive, which destabilizes the breathing pattern during sleep (in normo/hypocapnic patients). Central sleep apnoea can be the initial manifestation of Arnold-Chiari malformation and can lead to a life-threatening condition.     

Central nervous system and vertebral malformation resembling the Arnold-Chiari syndrome in a Simmental calf

We analysed 170 women with carcinoma of the breast who survived 20 years after local or loco-regional therapy, without adjuvant chemo-hormonotherapy. Patients with axillary lymph nodes metastases constitute thirty-six percent of this group.     

Two-headed, two-necked conjoined twin calf with Arnold-Chiari malformation in a Japanese shorthorn calf

Drugs having as their active substance aprotinin (trasylol, gordox, etc.) are widely indicated in the treatment of eye pathologies having as their basis an enhanced proteolytic enzyme activation. Our studies have exposed a decrease in proteolytic activity in both eye tissues and tear fluid in response to Gordox administration. Up to date there are no works concerning pharmacokinetics of aprotinin in the eye tissues. The aim of this work was to study the pharmacokinetics of 125I-aprotinin in rabbit eye tissues after instillation. A presence of the substance was registered in the cornea, aqueous humor, and ciliary body within a period of 10-90 minutes after administration, but not in other tissues. Calculation of the pharmacokinetic parameters of aprotinin penetration in the eye showed that its mean residence time in the cornea, aqueous humor and ciliary body was 50-60 min. The addition of polyvinyl alcohol to the instillation solution increased the level of the substance in the tissues, but did not change its mean residence time. The medicine should be instilled every 1-1.5 hrs to support high and stable levels of aprotinin in the eye.     

Spondylolysis associated with Arnold-Chiari malformation and syringomyelia. A report of two cases

STUDY DESIGN: This is a report of two cases. OBJECTIVE: To document the occurrence and association of spondylolysis and Arnold-Chiari malformation Type I. SUMMARY OF BACKGROUND DATA: The association of spinal dysraphism has been reported with Arnold-Chiari Type II, but not with Arnold-Chiari Type I. METHODS: The senior author was involved in the care of these patients. All medical records, laboratory and radiologic investigations, and related literature were reviewed. RESULTS: The presence of cephalic and caudal neuropore maldevelopment may be present in various combinations. The presence of spondylolysis, with or without spina bifida occulta, associated with Arnold-Chiari malformation type I and syringohydromyelia, is demonstrated. CONCLUSIONS: In some patients, the presence of spondylolysis may represent a congenital anomaly and may be associated with cephalic neuropore maldevelopment, such as cerebromedullary malformation syndrome (i.e., Arnold-Chiari malformation Type I).     

Mechanisms of sudden death and autopsy findings in patients with Arnold-Chiari malformation and ventriculoatrial catheters

Neurological and vascular complications of Arnold-Chiari malformation treated with ventriculoatrial shunting may result in sudden or unexpected death. Two patients with Arnold-Chiari malformation and ventriculoatrial shunting had variable clinical manifestations and diagnostic difficulties. A 3-year-old girl with a 1-day history of right-sided heart failure died unexpectedly soon after cardiac catheterization. At autopsy examination an adherent thrombus around the ventriculoatrial catheter tip, pulmonary infarction, and embolic pulmonary arterial hypertensive changes were found. In the second case, a 21-year-old man died suddenly after a brief episode of dyspnea. He had a 1-year history of "asthma" before death. Autopsy examination confirmed pulmonary infarction and embolic pulmonary arterial hypertensive changes. There was no histological evidence of asthma. Deaths in both cases were due to pulmonary infarction stemming from thromboemboli derived from ventriculoatrial catheterization. Both patients had evidence of long-standing clinically unsuspected vascular disease, which may have contributed to death. Cardiac catheterization may also have precipitated death in the first patient. Other possible problems leading or contributing to sudden death in such patients include pulmonary hypertension with chronic cor pulmonale, airway obstruction from recurrent laryngeal nerve paralysis, and shunt blockage with acute hydrocephalus. Lethal brainstem compression may also accompany relatively minor trauma associated with chronic cerebellar tonsillar herniation in these patients.     

Cruciate hemiplegia associated with basilar impression, Arnold-Chiari malformation and syringomyelia. Case report

The aim of this study was to determine the relationship between the radiological pattern of Mycoplasma pneumoniae and the level of cell-mediated immunity of the host. Computed tomographic (CT) scans of the chest and the results of the purified protein derivative (PPD) test were studied during the acute stage of infection in 54 patients with M. pneumoniae pneumonia. The CT findings were used to divide the patients into two groups: one group had a predominance of nodular opacities with a centrilobular distribution (Group N; n = 29); and the other showed a predominance of an airspace consolidation (Group C; n = 25). Forty out of 54 subjects had negative tuberculin skin tests ( < 10 mm induration). The positive rate of PPD reaction was higher in Group N (13 out of 29) compared to Group C (1 out of 25) (p = 0.0005); whilst pleural effusion appeared more frequently in Group C (10 out of 25) than in Group N (3 out of 29) (p = 0.023). There was no significant difference between Groups N and C in white blood cell and lymphocyte counts, level of antibodies to M. pneumoniae in sera, and severity of the disease. These findings suggest that the characteristics of the host cell-mediated immunity might influence the pattern of pulmonary lesions in M. pneumoniae infection.     

Congenital musculoskeletal malformation in South African Blacks: a study of incidence

Ten thousand South African Black neonates were examined on the day after delivery for assessment of the frequency of congenital malformation of the musculoskeletal system. In 15 neonates it was found that the hip joints could be dislocated by the Ortolani or Barlow techniques. This instability persisted to 1 week of age in only 3 instances. This incidence figure is approximately 10% of the average reported for White's neonates. Talipes equinovarus deformity was found in 35 infants, an incidence of 3,5/1 000, or approximately three times the incidence cited for Whites. Calcaneovalgus deformity, however, was found in 3 infants only-- a much lower incidence than that found among Whites. There was a similar infrequency in the incidence of spina bifida aperta (cystica), which was noted in 7 infants. This figure correlates with reports from North America, but is substantially lower than the cited incidence in Wales and parts of England. Polydactyly, usually consisting of a postaxial pedunculated skin tag only, was the most common deformity found, the incidence being 8,8/1 000.     

Hydrodynamic factors in Dandy-Walker and Arnold-Chiari malformations

The Dandy-Walker malformation (DWM) is hydrocephalus that primarily affects the fourth ventricle, whose overdistention involves also the aqueduct and third ventricle. However, just the opposite is true in the Arnold-Chiari malformation (ACM) since the hydrocephalus is limited to the lateral ventricles which squeeze the third ventricle between them and compress the aqueduct and fourth ventricle. The evidence indicates that both result from hydrodynamic stresses in embryonal and early fetal life. This communication is offered in rebuttal to some statements in an otherwise authoritative and comprehensive article.     

Copper deficiency in a herd of captive muskoxen

At necropsy, a mature muskox cow was found to have exceedingly low serum and liver copper concentrations of 4.8 = mumol/L and 0.02 mmol/kg, respectively. Serum copper levels were also low in remaining members of the herd but returned to normal after parenteral treatment with calcium copper edetate.     

Segmental muscular hypertrophy in Arnold-Chiari deformity associated with syringomyelia syndrome

A case of Arnold-Chiari malformation plus syringomyelic syndrome with hypertrophy of upper left and lower right limbs is reported. The pathogenesis of this muscular hypertrophy is discussed. The authors retain the idea of an added malformation.     

Evolution of atypical gynecological cervical smears in a captive population

BACKGROUND: An atypical cervical smear may represent a wide variety of lesions, from banal diseases to invasive neoplastic lesions. AIM: To study the evolution of atypical cervical smears in a highly controlled women population. MATERIAL AND METHODS: A retrospective analysis of 117 women with atypical cervical smears, diagnosed between 1985 and 1994, was performed at the institutional hospital of a mining corporation in Chile. RESULTS: Patients age ranged from 25 to 65 years. Six percent of atypical cervical smears were associated to Papillomavirus infection and 25% to unspecific infectious agents. In the second smear, during follow up, 22.2% of women had some degree of squamous intraepithelial lesion or signs of Papillomavirus infection. A cervical biopsy was performed to 69 women, confirming the presence of a squamous intraepithelial neoplasia or signs of Papillomavirus infection in 38.4% of them. Only one patient had microinvasion. CONCLUSIONS: All patients with atypical gynecological cervical smears should be closely followed to ascertain the diagnosis.     

Mycobacterial osteomyelitis in captive marsupials

Mycobacterial osteomyelitis was detected in 3 marsupials exhibited at the National Zoological Park, Washington, DC. One Matschiei's tree kangaroo (Dendrolagus matschiei), 1 Parma wallaby (Macropus parma), and 1 long-nosed rat kangaroo (Potorous tridactylus) were affected. The Parma wallaby had disseminated granulomatosis. Acid-fast organisms were observed in the bone marrow of the wallaby, using the auramine-O-rhodamine fluorescent technique; however, cultures were negative. The tibiotarsal joint of the rat kangaroo contained exudate, with fistulous tracts and necrosis of the articular surface. Granulomas with necrotic centers from this area were positive by auramine-O-rhodamine but were negative on culture. The tree kangaroo had thickening of the right ischium, with a pocket of exudate caudal to the acetabulum. The musculature in the acetabular area was thickened and fibrotic. Mycobacterium avium serotype 15 was isolated from the ischium and liver of this animal.     

Cerebral nematodiasis in captive nutria

Of 35 nutria (Myocaster coypus) at a city zoo, 20 died or were killed because of a progressive central nervous system disease. On the basis of histopathologic findings, a diagnosis of cerebral nematodiasis complicated by nosematosis was made. The only significant management change prior to illness was the feeding of poplar tree branches from a lowland area inhabited by skunks and raccoons. Neurologic disturbances gradually ceased within 2 months after control measures were initiated and the practice of provided poplar branches as a source of roughage was discontinued.     

Tuberculosis in captive exotic birds

Avian tuberculosis was studied clinically and pathologically in 137 affected birds from the National Zoological Park during a 7-year period (1969-1975). Twelve of 22 orders exhibited were affected by the disease, and the highest annual mortality was 4% (in 1975). Antemortem diagnosis of early cases of the disease, based on tuberculin testing, and serologic, hematologic, and radiographic studies, was inconsistent and often not conclusive. Pathologically, the diseases primarily involved digestive organs and spleen. There was a spectrum of lesions consisting of nodules of large foamy histiocytes packed with acid-fast bacilli to giant cell-containing granulomas that were often caseous but not cavitated or calcified. Amyloidosis was seen in approximately 20% of the cases. Mycobacterium avium serotype 1 was isolated from 30 tuberculous birds cultured. There was no sex predilection, and most of the affected birds were adults ranging from 1 to 10 years of age.