This is a case report of Arnold-Chiari malformation. The patient is 34 years old male who is revealing slowly progressive walking difficulty, occipital headache, cerebellar signs and sensory symptoms. The CTMM findings are bilateral herniated tonsils behind cervical cord with compression on posterior margin of cord.
Adult ; Arnold-Chiari Malformation* ; Headache ; Humans ; Male ; Palatine Tonsil ; Walking

The diagnosis of olivopontocerebellar atrophy (OPCA) was previously based on postmortem pathological findings. Recently, however, the various gross anatomical changes of the central nervous system can be defined by the high resolution CT sean, which can make a diagnosis of several degenerative diseases on a clinical basis. This report analyzes 15 cases who showed significant pontocerebellar degeneration on the CT brain scan, including 5 cases of serial studies. All cases were Korean and onset was between 31 to 63 years of age with about 3 time female preponderance. Two patients were in one family suggesting hereditary process. The initial symptoms were ataxic gait, dysarthria, paraparesis, dizziness, and tremors in orders. On examination, the most common clinical maifestations were dysarthria (80%), cerebellar dysfunctions (73.3%) and hyper-reflexia (73.3%). Other findings included parapresis, nystagmus, pathological reflexes and hemiparesis. Characteristically, there were no sensory or mental deficits. The progression of the symptoms tended to parall the CT scans on serial studies. The evoked potential studies including brainstem auditory evoked potential revealed no significant abnormalities exept one case who showed only borderine prolongation of interwave latency between wave 1 and 3. The responses on antiparkinson regimens were fruitless.
Atrophy* ; Brain* ; Central Nervous System ; Cerebellar Diseases ; Diagnosis ; Dizziness ; Dysarthria ; Evoked Potentials ; Evoked Potentials, Auditory, Brain Stem ; Female ; Gait ; Humans ; Olivopontocerebellar Atrophies ; Paraparesis ; Paresis ; Reflex ; Tomography, X-Ray Computed ; Tremor

Little is known about processing mechanism of sensory input from the periodontal ligaments to the trigeminal motor nucleus for the control of chewing force and modulation of chewing pattern. Low threshold mechanoreceptive periodontal afferent was labeled with horseradish peroxidase by use of intra-axonal injection technique and investigated with electron microscopy. Quantitative ultrastructural analysis was performed on the 39 serially reconstructed labeled boutons in the trigeminal motor nucleus in cat. Labeled bouton contained clear spherical vesicles and one or two large dense cored vesicles. Most of labeled boutons were dome or round shape. All the analysed labeled boutons were presynaptic to dendritic shaft or distal dendrite and those presynaptic to soma or proximal dendrite were not observed. A large number of labeled boutons (46.2%) were postsynaptic to one or two presynaptic pleomorphic vesicle containing endings. Synaptic triad, in that a presynaptic ending which is presynaptic to the labeled bouton, in turn, is presynaptic to dendrite that is postsynaptic to the labeled bouton, was observed in 10.3% of the labeled boutons. Most of the labeled boutons showed simple synaptic organization, in that 64.1% of the labeled boutons made synaptic contacts with one or two neuronal profiles. One (2.6%) of the 39 analyzed labeled boutons showed synaptic contacts with 5 or more neuronal profiles. Labeled bouton volume, mitochondrial volume, apposed surface area and active zone area showed wide variation. These ultrastructural parameters were positively correlated with bouton volume. The values for apposed surface area and active zone area with presynaptic p-endings, in contrast to those with postsynaptic dendrites, showed narrow range and had little correlation with bouton volume. The present study revealed characteristic features on ultrastructural parameters of labeled boutons from periodontal afferent which is involved in periodontal masseteric reflex, and that influence on the postsynaptic trigeminal motoneurons showed wide variability.
Animals ; Carisoprodol ; Cats ; Dendrites ; Horseradish Peroxidase ; Mastication ; Microscopy, Electron ; Mitochondrial Size ; Neurons ; Periodontal Ligament ; Reflex ; Synapses