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Since the first detailed description of basophilic granules in nerve cells by Nissl in 1895, there has been constant discussion concerning the chemical structure and the function of this densely staining granular substance, and important new findings have been published in the last ten years. The first part of this paper reviews, therefore, the progress made on the chemistry and electronmicroscopical structure of the Nissl body, followed by a detailed description of the electronmicroscopical structure of interneuronal connexions, the synapses. The last section of the paper is dedicated to the structure and function of the neuroglia, work which has been accumulated since the author published his monograph in 1955. This section also discusses the construction of cerebral capillaries, the problems of intercellular space and the blood-brain barrier.

Malignant Hyperpyrexia (MH), a high mortality complication of general anaesthesia, has recently been associated with patients having subclinical myopathy. This paper reports histochemical abnormalities found in the muscle of the families of two patients who developed MH. The Ca-EDTA method was used to demonstrate a decreased myofibrillar ATP-ase content in the fibre population. No morphological abnormality was found.

In the first of a series of papers about large scale surveys of biochemical parameters in Multiple Sclerosis, the authors report about the detailed study of most of the plasma lipid fractions of a group of 484 Multiple Sclerosis patients and compare them to a group of 152 patients with other neurological diseases. The results are studied according to sex and different age groups. All determinations were made within a period of 2 years using strictly standardized conditions. No significant differences that would distinguish the M.S. patients from the other neurological cases could be found for any of the different subclasses of plasma lipids studied.

This paper deals with the problems of metabolic acidosis and lesions of the CNS. It is necessary to divide the results into two categories: one summarizing acid base dysregulations in the blood with secondary impairment of the functions of the CNS, the other discussing primary CNS lesions and consequent CSF acidosis. It is important that in the first category there is a strong regulation between the HCO3-concentrations in the blood and those in the CSF over the wide range from acidosis to alkalosis. In the second category there is a very marked CSF bicarbonate deficiency while in the blood the acid-base balance can be within the normal range. In these cases of primary metabolic CSF acidosis (PMA(CSF)) there is no relation between blood and CSF HCO3-concentrations. In the presence of a primary cerebral lesion, the CSF acidosis is often combined with rise in the level of lactic acid and pyruvic acid in the CSF and an elevation of the lactate/pyruvate ratio reflecting cerebral hypoxia. But it is necessary to point out that in a special group of PMA(CSF) the disturbances are caused directly by intracranial infections with organisms producing lactic acid, for instance in the case of pneumococcal meningitis. The possible complications and the therapy of acid-base disturbances in both categories are discussed.

The present paper gives an introduction to fundamental pathologic features of various diseases of the peripheral nervous system, such as Wallerian degeneration, axonal degeneration, segmental degeneration, primary impairment of the endoneural interstitium. It is based on electron-microscope analysis. The range of reactions available to the peripheral nervous system is limited; thus noxious influences of various etiologies will act via largely common pathogenic mechanisms to produce similar morphologic changes.

The paper presents the clinical features and laboratory data of a 6-year-old boy with centronuclear myopathy. No familial susceptibility was disclosed. The clinical signs are displayed with a congenital foot deformity and with the child's beginning to walk further symptoms and signs appeared. They simulated the picture of the limb-girdle type of muscular dystrophy. EMG findings showed myopathic type of motor unit disintegration at the muscle level. The morphological examination disclosed the characteristic features of the disease: central sarcolemmal nuclear and perinuclear loss of myofibrils. These changes affected both types of muscle fibers.

Summary Using 101 cases with cerebral concussions or contusions, whose first EEG had been taken within the first four weeks after the accident, the problem was examined, how frequently the trauma gives rise to a transitory voltage depression. A certain depression could be seen in most cases. The EEG of ten persons could not be distinguished from the „low voltage type“, which had been characterized in an earlier paper as a fairly distinct and in many cases dominantly inherited EEG variant. A short time after the trauma, transitory low voltage patterns seem to be especially frequent. They may be, but must not be combined with other — general or focal — abnormalities. The importance of genetic examinations (twin and family data) for the differential diagnosis of these cases is stressed. In this connection, some examples for the use of twin data in EEG diagnosis are given.

During a time period of 8 years 55 female patients between age 15 and 40 with cerebrovascular accidents (CVA) were seen by us. 19 were pregnant, 9 had migraine accompagnéc, 2 showed embolisms, 3 had a hematologic disorder, in 2 cases there was juvenile subcortical bleeding, 2 had a thrombosis of the internal carotid artery, and in 5 cases no specific etiological factor was found. The remaining 11 cases were young women taking the “pill” at the time of the CVA. Two other patients age 42 and 45 years, respectively, with a CVA were on the same medication, and in still 2 more females the medication had precipitated migraine accompagnée followed by cerebrovascular accident. One patient with a CVA during the first month of her pregnancy had taken an oral contraceptive for the 2 preceding years. Adding 4 more females seen after the manuscript of this paper was submitted we have by now observed a total of 20 patients in whom the pill may be implicated in the development of a CVA. The average age of the patients was 29 years. The drug regimens comprised 7 different brands which had bee taken for periods from 14 days to 36 months. In 17 cases hemiplegia was present, and in 2 others there was a global amnestic episode. On the basis of our observations and of 80 cases reported in the medical literature pathogenetic mechanisms of the “pill” are discussed. Statistic evidence supports the assumption that it may play a pathogenetic role, as does experimental work on the influence of contraceptives on blood clotting mechanisms and on histologic alterations of the vascular walls. Common features of the state of pregnancy and the administration of the “pill” are stressed.

The present paper is a clinicoanatomical study of a 49-year-old male patient who developed bilateral thrombosis of the internal carotids in two stages. Histological findings included proliferation of the intima of the affected carotids with secondary recanalization in the absence of impaired internal elastic lamina. Proliferation of the intima was also present in the common carotids, right subclavian and left vertebral arteries presenting the typical picture of Buerger's disease.