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In spite of the clear differentiation between various heredofamilial neurologic syndromes, many instances of transitional forms have been described from both the clinical and the pathologic viewpoint, particularly among the syndromes of Friedreich's ataxia, Marie's heredocerebellar ataxia, Charcot-Marie-Tooth peroneal muscular atrophy, hereditary spastic paralysis and Leber's hereditary optic nerve atrophy. This report concerns a disease occurring in 3 siblings which does not easily fall under any previously described disease entity. Clinically the condition in 1 case resembled infantile progressive spinal atrophy (Werdnig-Hoffmann disease). Histopathologically it was related to amaurotic family idiocy (Tay-Sachs disease) but presented changes that are also seen in other, supposedly unrelated, forms of heredofamilial disorder. REPORT OF CASES The 3 cases occurred in a family in which no previous nervous disorder was known. Both parents were born in Ireland, of Irish stock. During the course of twenty years the mother had been pregnant fourteen times, eleven of

The nature and effects of injury to the brain have been the subject of investigation since earliest recorded medical history. Gross injuries of the brain and their effects are fairly well understood, but the effects of concussion, or indeed, the cause of unconsciousness, are less well known and are still the subject of discussion and controversy, which occupy the attention of the clinician and the pathologist. REVIEW OF THE LITERATURE The literature on concussion up to recent years has been well covered in the important article of Jakob,1 who repeated the classic experiment of Schmaus2 on the spinal cord of the rabbit and extended the experiments to concussion of the brain. Schmaus reported four observations on the human subject in which concussion of the spinal cord produced a direct specific action on the primary tissues of the nervous system. In order to study further the effects of concussion

In a previous study1 we investigated the nature of traumatic petechial hemorrhages in 11 human brains, the interval of survival after trauma varying from an unmeasurable period, designated for lack of a better term, perhaps improperly, as "immediate death," to eight days. All brains, studied by careful histologic methods, showed perivascular petechiae. They were frequent about the arterioles. The different forms and states of petechiae, as well as their location in the brain substance, were described. A theory was advanced as to the formation of ring and ball hemorrhages from fresh petechiae. The data obtained led to the conclusion that multiple petechial hemorrhages are a characteristic finding in cases of severe concussion of the brain and are dependent on vasodilatation, vascular stasis (prestasis) and anoxemia, and that mild, reversible concussion effects on the parenchyma of the brain should be distinguished from severe, irreversible concussion effects. The possible relationship of