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September 1982, Vol 39, No. 9 >
Article | September 1982

Posttraumatic Premature Alzheimer's Disease: Title and subTitle BreakNeuropathologic Findings and Pathogenetic Considerations

Raul Rudelli, MD; John O. Strom, MD; Paul T. Welch, MD; Mary W. Ambler, MD
[+] Author Affiliations

Accepted for publication Aug 8, 1981.

Read in part before the 56th annual meeting of the American Association of Neuropathology, New Orleans, June 14, 1980.

Reprint requests to Rhode Island Hospital, 593 Eddy St, Providence, RI 02902 (Dr Ambler).


Arch Neurol. 1982;39(9):570-575. doi:10.1001/archneur.1982.00510210040009
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Article
References
Comments

Dementia following head trauma is generally attributed to contusional injury or its complications. Dementia pugilistica and rare cases of classic Alzheimer's disease (AD) following head injury suggest that trauma may also play a provocative role in neurofibrillary change. The ages and clinical descriptions, however, allow other interpretations. A 38-year-old man died 16 years after substantial recovery from a single episode of severe head trauma. Pathologic study indicated that the clinical deterioration was due to classic AD. Ultrastructural evaluation demonstrated both paired helical and straight filaments in cortical neurons.

REFERENCES

1 +
Brandenburg W, Hallervorden J:  Dementia pugilistica mit anatomischem Befund . Virchows Arch Pathol Anat 1954;;325:680-709.
2 +
Grahmann H, Ule G:  Beitrag zur Kenntnis der cronischen cerebralen Krankheitsbilder bei Boxern . Psychiatr Clin 1957;;134:261-283.
3 +
Critchley M:  Medical aspects of boxing, particularly from a neurological standpoint . Br Med J 1957;;1:357-366.
4 +
Ferguson FR, Mawdsley C: Chronic encephalopathy in boxers. Program and abstracts of the Eighth International Congress of Neurology, Vienna, 1965, pp 81-84.
5 +
Constantinidis J, Tissot R:  Lesions neurofibrillaires d'Alzheimer generalisees sans plaques seniles . Schweiz Arch Neurol Neurochir Psychiatr 1967;;100:117-130.
6 +
Corsellis JAN, Bruton CJ, Freeman-Browne D:  The aftermath of boxing . Psychol Med 1973;;3:270-303.
7 +
Corsellis JAN:  Post-traumatic dementia , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 125-133.
8 +
Wisniewski HM, Narang HK, Corsellis JAN, et al:  Ultrastructural studies of the neuropil and neurofibrillary tangles in Alzheimer's disease and post-traumatic dementia . J Neuropathol Exp Neurol 1976;;35:367.
9 +
Claude H, Cuel J:  Demence pre-senile post-traumatique apres fracture du crane: Considerations medico-legales . Ann Med Legal 1939;;19:173-184.
10 +
Corsellis JAN, Brierley JB:  Observations on the pathology of insidious dementia following head injury . J Ment Sci 1959;;105:714-720.
11 +
Hollander D, Strich S:  Atypical Alzheimer's disease with congophilic angiopathy presenting with dementia of acute onset , in Wolstenholme GEW, O'Connor M (eds): Alzheimer's Disease and Related Conditions . New York, Churchill Livingstone, 1970;, pp 105-135.
12 +
Khaime TSB:  Role of craniocerebral trauma in the development of Alzheimer's disease . Zh Nevropatol Psikhiatr 1976;;76:1028-1032.
13 +
Giménez-Roldan S, Peraita P, Lopez Agreda JM, et al:  Myoclonus and photic-induced seizures in Alzheimer's disease . Eur Neurol 1971;;5:215-224.
14 +
Heston LL:  Alzheimer's disease, trisomy 21 and myeloproliferative disorders: Associations suggesting a genetic diathesis . Science 1977;;196:322-323.
15 +
Heston LL, Mastri AR:  The genetics of Alzheimer's disease: Associations with myeloproliferative disorders and Down's syndrome . Arch Gen Psychiatry 1977;;34:976-981.
16 +
Cook RN, Ward BE, Austin JH:  Studies in aging of the brain: IV. Familial Alzheimer disease: Relation to transmissible dementia, aneuploidy, and microtubular defects . Neurology 1979;;29:1402-1412.
17 +
Wisniewski K, Howe J, Williams DG, et al:  Precocious aging and dementia in patients with Down's syndrome . Biol Psychiatry 1978;;13:619-627.
18 +
Hillbom E:  After-effects of brain injuries . Acta Psychiatr Scand Suppl 1960;;35:142.
19 +
Achte KA, Hillbom E, Aalberg V:  Psychoses following war brain injuries . Acta Psychiatr Scand 1969;;45:1-18.
20 +
Symonds CP:  Concussion and contusion of the brain and their sequelae , in Feiring EH (ed): Brock's Injuries of the Brain and Spinal Cord , ed 5. New York, Springer Publishing Co Inc, 1974;, pp 100-161.
21 +
Lishman WA:  Brain damage in relation to psychiatric disability after head injury . Br J Psychiatry 1968;;114:373-410.
22 +
Lishman WA:  The psychiatric sequelae of head injury: A review . Psychol Med 1973;;3:304-318.
23 +
Bond M:  Assessment of the psychosocial outcome of severe head injury: Outcome of severe damage to the central nervous system . Ciba Found Symp 1975;;34:141-153.
24 +
Newcombe F: Missile Wounds of the Brain . London, Oxford University Press, 1968;.
25 +
Weinstein S:  Differences in effects of brain wounds implicating right or left hemispheres , in Mountcastle VB (ed): Interhemispheric Relations and Cerebral Dominance . Baltimore, The Johns Hopkins Press, 1962;, pp 159-176.
26 +
Miller H, Stern G:  The long-term prognosis of severe head injury . Lancet 1965;;1:225-229.
27 +
Miller H:  Mental after-effects of head injury . Proc R Soc Med 1966;;59:257-261.
28 +
Moore BE, Ruesch J:  Prolonged disturbances of consciousness following head injury . N Engl J Med 1944;;230:445-452.
29 +
Strich SJ:  Diffuse degeneration of the cerebral white matter in severe dementia following head injury . J Neurol Neurosurg Psychiatry 1956;;19:163-185.
30 +
Strich SJ: Altered states of consciousness due to white matter degeneration. Proceedings of the First International Congress of Neurological Sciences, Brussels, 1957, pp 111-118.
31 +
Carlsson CA, von Essen C, Lofgren J:  Factors affecting the clinical course of patients with severe head injuries . J Neurosurg 1968;;29:242-251.
32 +
Gayral L, Moron P:  Demences post-traumatiques . Rev Practicien 1966;;16:3125-3135.
33 +
Parker N:  Post-traumatic dementia . Proc Aust Assoc Neurol 1969;;16:39-44.
34 +
Mifka P:  Post-traumatic psychiatric disturbances , in Vinken PJ, Bruyn GW, Braakman R (eds): Handbook of Clinical Neurology . New York, Elsevier North Holland Inc, 1976;, vol 24: Injuries of the Brain and Skull, pp 517-574.
35 +
Kretschmer E:  Das apallische Syndrom . Zh Neurol Psychiatr 1940;;169:576-579.
36 +
Gerstenbrand F: Das Traumatische Apallische Syndrom . Vienna, Springer-Verlag, 1967;.
37 +
Jennett B, Plum F:  Persistent vegetative state after brain damage: A syndrome in search of a name . Lancet 1972;;1:734-737.
38 +
Jellinger K, Seitelberger F:  Protracted post-traumatic encephalopathy: Pathology, pathogenesis and clinical implications . J Neurol Sci 1970;;10:51-94.
39 +
McKissock W:  Subdural hematoma: A review of 389 cases . Lancet 1960;;1:1365-1369.
40 +
Trelles JO, Cuba JM, Palomino L:  La forma demencial de los hematomas subdurales cronicos . Rev Neuropsiquiatr 1968;;31:1-16.
41 +
Lewin W:  Preliminary observation on external hydrocephalus after severe head injury . Br J Surg 1968;;55:747-751.
42 +
Zander E, Foroglou G:  Post-traumatic hydrocephalus , in Vinken PJ, Bruyn GW Braakman R (eds): Handbook of Clinical Neurology . New York, Elsevier North Holland Inc, 1976;, vol 24: Injuries of the Brain and Skull, pp 231-253.
43 +
Jennett WB: Epilepsy After Non-Missile Head Injuries . London, Heinemann Educational Books, 1974;.
44 +
Jennett WB:  Post-traumatic epilepsy , in Thompson RA, Green JR (eds): Advances in Neurology . New York, Raven Press, 1979;, vol 22: Complications of Nervous System Trauma, pp 137-147.
45 +
Alzheimer A:  Über eine eigenartige Erkrankung der Hirnrinde . Allg Z Psychiatr 1907;;64:146-148.
46 +
Boyd DA:  A contribution to the psychopathology of Alzheimer's disease . Am J Psychiatry 1936;;93:155-175.
47 +
Sim M, Sussman I:  Alzheimer's disease: Its natural history and differential diagnosis . J Nerv Ment Dis 1962;;135:489-499.
48 +
Wisniewski HM, Terry RD:  Reexamination of the pathogenesis of the senile plaque , in Zimmermann HM (ed): Progress in Neuropathology . New York, Grune & Stratton Inc, 1973;, vol 2, pp 1-26.
49 +
Wisniewski HM, Terry RD:  Neuropathology of the aging brain , in Terry RD, Gershon S (eds): Neurobiology of Aging . New York, Raven Press, 1976;, pp 265-280.
50 +
Hirano A, Zimmerman HM:  Alzheimer's neurofibrillary changes: A topographic study . Arch Neurol 1962;;7:227-242.
51 +
Wisniewski H, Terry RD, Hirano A:  Neurofibrillary pathology . J Neuropathol Exp Neurol 1970;;29:163-176.
52 +
Hirano A, Dembitzer HM, Kurland LT, et al:  The fine structure of some intraganglionic alterations . J Neuropathol Exp Neurol 1968;;27:167-182.
53 +
Tomlinson BE, Blessed G, Roth M:  Observations on the brains of nondemented old people . J Neurol Sci 1968;;7:331-356.
54 +
Wisniewski K, Jervis GA, Moretz RC, et al:  Alzheimer neurofibrillary tangles in diseases other than senile and presenile dementia . Ann Neurol 1979;;5:288-294.
55 +
Mandybur TI, Nagpaul AS, Pappas Z, et al:  Alzheimer neurofibrillary changes in subacute sclerosing panencephalitis . Ann Neurol 1977;;1:103-107.
56 +
Chou SM, Thompson HG:  Electron microscopy of storage cytosomes in Kufs' disease . Arch Neurol 1970;;23:489-501.
57 +
Hirano A, Malamud N, Elizan TS, et al:  Amyotrophic lateral sclerosis and parkinsonism-dementia complex on Guam . Arch Neurol 1966;;15:35-51.
58 +
Faden AI:  Myoclonus in Alzheimer disease . Arch Neurol 1976;;33:278-280.
59 +
Kidd M:  Alzheimer's disease: An electron microscopy study . Brain 1964;;87:307-327.
60 +
Terry RD, Gonatas NK, Weiss M:  Ultrastructural studies in Alzheimer's presenile dementia . Am J Pathol 1964;;44:269-297.
61 +
Wisniewski HM, Narang HK, Terry RD:  Neurofibrillary tangles of paired helical filaments . J Neurol Sci 1976;;27:173-181.
62 +
Schochet SS Jr, Lampert PN, McCormick WF:  Neurofibrillary tangles in patients with Down's syndrome: A light and electron microscopic study . Acta Neuropathol 1973;;23:342-346.
63 +
Hadfield MG, Martinez AJ, Gilmartin RC:  Progressive multifocal leukoencephalopathy with paramyxovirus-like structures, Hirano bodies and neurofibrillary tangles . Acta Neuropathol 1974;;27:277-288.
64 +
Horoupian DS, Yang SS:  Paired helical filaments in neurovisceral lipidosis (juvenile dystonic lipidosis) . Ann Neurol 1978;;4:404-411.
65 +
Tellez-Nagel I, Wisniewski HM:  Ultrastructure of neurofibrillary tangles in Steele-Richardson-Olszewski syndrome . Arch Neurol 1973;;29:324-327.
66 +
Rewcastle NB:  The 15 nm filament neurofibrillary tangle . Neuropathol Appl Neurobiol 1976;;2:490.
67 +
Tomonaga M:  Ultrastructure of neurofibrillary tangles in progressive supranuclear palsy . Acta Neuropathol 1977;;37:177-181.
68 +
Shibayama H, Kitoh J:  Electron microscopic structure of the Alzheimer's neurofibrillary changes in case of atypical senile dementia . Acta Neuropathol 1978;;41:229-234.
69 +
Yagishita S, Itoh Y, Amano N, et al:  Ultrastructure of neurofibrillary tangles in progressive supranuclear palsy . Acta Neuropathol 1979;;48:27-30.
70 +
Plobst A:  Degenerescence neurofibrillaire sous-corticale senile avec presence de tubule contournes et de filaments droits: Forme atypique de la paralysie supranuclear progressive . Rev Neurol 1977;;133:417-428.
71 +
Lampert P:  Fine structural changes of neurites in Alzheimer's disease . Acta Neuropathol , 1971;, (suppl 5) , pp 49-53.
72 +
Griffiths RI, Miller R:  Vascular permeability to protein and vasogenic edema in experimental concussive injuries to the canine spinal cord . J Neurol Sci 1974;;22:291-304.
73 +
Ishii T:  Enzyme histochemical studies of senile plaques and the plaque-like degeneration of arteries and capillaries . Acta Neuropathol 1969;;14:250-260.
74 +
Wisniewski HM, Johnson AB, Raine CS, et al:  Senile plaques and cerebral amyloidosis in aged dogs . Lab Invest 1970;;23:287-296.
75 +
Skalickova O, Jezkova Z, Slavickova V:  Immunological aspects of psychiatric gerontology . Rev Czech Med 1962;;8:264-275.
76 +
Ishii T, Hoga S:  Immuno-electronmicroscopic localization of immunoglobulins in senile plaques by means of fluorescent antibody techniques . Acta Neuropathol 1975;;32:157-162.
77 +
Wisniewski HM:  Possible viral etiology of neurofibrillary changes and neuritic plaques , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 555-558.
78 +
Johnson RT:  Viral etiology in amentias and dementias , in Katzman R (ed): Congenital and Acquired Cognitive Disorders . New York, Raven Press, 1979;, pp 177-187.
79 +
Scheinberg IH:  Toxicity of heavy metals to the central nervous system , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 487-491.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Brandenburg W, Hallervorden J:  Dementia pugilistica mit anatomischem Befund . Virchows Arch Pathol Anat 1954;;325:680-709.
2 +
Grahmann H, Ule G:  Beitrag zur Kenntnis der cronischen cerebralen Krankheitsbilder bei Boxern . Psychiatr Clin 1957;;134:261-283.
3 +
Critchley M:  Medical aspects of boxing, particularly from a neurological standpoint . Br Med J 1957;;1:357-366.
4 +
Ferguson FR, Mawdsley C: Chronic encephalopathy in boxers. Program and abstracts of the Eighth International Congress of Neurology, Vienna, 1965, pp 81-84.
5 +
Constantinidis J, Tissot R:  Lesions neurofibrillaires d'Alzheimer generalisees sans plaques seniles . Schweiz Arch Neurol Neurochir Psychiatr 1967;;100:117-130.
6 +
Corsellis JAN, Bruton CJ, Freeman-Browne D:  The aftermath of boxing . Psychol Med 1973;;3:270-303.
7 +
Corsellis JAN:  Post-traumatic dementia , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 125-133.
8 +
Wisniewski HM, Narang HK, Corsellis JAN, et al:  Ultrastructural studies of the neuropil and neurofibrillary tangles in Alzheimer's disease and post-traumatic dementia . J Neuropathol Exp Neurol 1976;;35:367.
9 +
Claude H, Cuel J:  Demence pre-senile post-traumatique apres fracture du crane: Considerations medico-legales . Ann Med Legal 1939;;19:173-184.
10 +
Corsellis JAN, Brierley JB:  Observations on the pathology of insidious dementia following head injury . J Ment Sci 1959;;105:714-720.
11 +
Hollander D, Strich S:  Atypical Alzheimer's disease with congophilic angiopathy presenting with dementia of acute onset , in Wolstenholme GEW, O'Connor M (eds): Alzheimer's Disease and Related Conditions . New York, Churchill Livingstone, 1970;, pp 105-135.
12 +
Khaime TSB:  Role of craniocerebral trauma in the development of Alzheimer's disease . Zh Nevropatol Psikhiatr 1976;;76:1028-1032.
13 +
Giménez-Roldan S, Peraita P, Lopez Agreda JM, et al:  Myoclonus and photic-induced seizures in Alzheimer's disease . Eur Neurol 1971;;5:215-224.
14 +
Heston LL:  Alzheimer's disease, trisomy 21 and myeloproliferative disorders: Associations suggesting a genetic diathesis . Science 1977;;196:322-323.
15 +
Heston LL, Mastri AR:  The genetics of Alzheimer's disease: Associations with myeloproliferative disorders and Down's syndrome . Arch Gen Psychiatry 1977;;34:976-981.
16 +
Cook RN, Ward BE, Austin JH:  Studies in aging of the brain: IV. Familial Alzheimer disease: Relation to transmissible dementia, aneuploidy, and microtubular defects . Neurology 1979;;29:1402-1412.
17 +
Wisniewski K, Howe J, Williams DG, et al:  Precocious aging and dementia in patients with Down's syndrome . Biol Psychiatry 1978;;13:619-627.
18 +
Hillbom E:  After-effects of brain injuries . Acta Psychiatr Scand Suppl 1960;;35:142.
19 +
Achte KA, Hillbom E, Aalberg V:  Psychoses following war brain injuries . Acta Psychiatr Scand 1969;;45:1-18.
20 +
Symonds CP:  Concussion and contusion of the brain and their sequelae , in Feiring EH (ed): Brock's Injuries of the Brain and Spinal Cord , ed 5. New York, Springer Publishing Co Inc, 1974;, pp 100-161.
21 +
Lishman WA:  Brain damage in relation to psychiatric disability after head injury . Br J Psychiatry 1968;;114:373-410.
22 +
Lishman WA:  The psychiatric sequelae of head injury: A review . Psychol Med 1973;;3:304-318.
23 +
Bond M:  Assessment of the psychosocial outcome of severe head injury: Outcome of severe damage to the central nervous system . Ciba Found Symp 1975;;34:141-153.
24 +
Newcombe F: Missile Wounds of the Brain . London, Oxford University Press, 1968;.
25 +
Weinstein S:  Differences in effects of brain wounds implicating right or left hemispheres , in Mountcastle VB (ed): Interhemispheric Relations and Cerebral Dominance . Baltimore, The Johns Hopkins Press, 1962;, pp 159-176.
26 +
Miller H, Stern G:  The long-term prognosis of severe head injury . Lancet 1965;;1:225-229.
27 +
Miller H:  Mental after-effects of head injury . Proc R Soc Med 1966;;59:257-261.
28 +
Moore BE, Ruesch J:  Prolonged disturbances of consciousness following head injury . N Engl J Med 1944;;230:445-452.
29 +
Strich SJ:  Diffuse degeneration of the cerebral white matter in severe dementia following head injury . J Neurol Neurosurg Psychiatry 1956;;19:163-185.
30 +
Strich SJ: Altered states of consciousness due to white matter degeneration. Proceedings of the First International Congress of Neurological Sciences, Brussels, 1957, pp 111-118.
31 +
Carlsson CA, von Essen C, Lofgren J:  Factors affecting the clinical course of patients with severe head injuries . J Neurosurg 1968;;29:242-251.
32 +
Gayral L, Moron P:  Demences post-traumatiques . Rev Practicien 1966;;16:3125-3135.
33 +
Parker N:  Post-traumatic dementia . Proc Aust Assoc Neurol 1969;;16:39-44.
34 +
Mifka P:  Post-traumatic psychiatric disturbances , in Vinken PJ, Bruyn GW, Braakman R (eds): Handbook of Clinical Neurology . New York, Elsevier North Holland Inc, 1976;, vol 24: Injuries of the Brain and Skull, pp 517-574.
35 +
Kretschmer E:  Das apallische Syndrom . Zh Neurol Psychiatr 1940;;169:576-579.
36 +
Gerstenbrand F: Das Traumatische Apallische Syndrom . Vienna, Springer-Verlag, 1967;.
37 +
Jennett B, Plum F:  Persistent vegetative state after brain damage: A syndrome in search of a name . Lancet 1972;;1:734-737.
38 +
Jellinger K, Seitelberger F:  Protracted post-traumatic encephalopathy: Pathology, pathogenesis and clinical implications . J Neurol Sci 1970;;10:51-94.
39 +
McKissock W:  Subdural hematoma: A review of 389 cases . Lancet 1960;;1:1365-1369.
40 +
Trelles JO, Cuba JM, Palomino L:  La forma demencial de los hematomas subdurales cronicos . Rev Neuropsiquiatr 1968;;31:1-16.
41 +
Lewin W:  Preliminary observation on external hydrocephalus after severe head injury . Br J Surg 1968;;55:747-751.
42 +
Zander E, Foroglou G:  Post-traumatic hydrocephalus , in Vinken PJ, Bruyn GW Braakman R (eds): Handbook of Clinical Neurology . New York, Elsevier North Holland Inc, 1976;, vol 24: Injuries of the Brain and Skull, pp 231-253.
43 +
Jennett WB: Epilepsy After Non-Missile Head Injuries . London, Heinemann Educational Books, 1974;.
44 +
Jennett WB:  Post-traumatic epilepsy , in Thompson RA, Green JR (eds): Advances in Neurology . New York, Raven Press, 1979;, vol 22: Complications of Nervous System Trauma, pp 137-147.
45 +
Alzheimer A:  Über eine eigenartige Erkrankung der Hirnrinde . Allg Z Psychiatr 1907;;64:146-148.
46 +
Boyd DA:  A contribution to the psychopathology of Alzheimer's disease . Am J Psychiatry 1936;;93:155-175.
47 +
Sim M, Sussman I:  Alzheimer's disease: Its natural history and differential diagnosis . J Nerv Ment Dis 1962;;135:489-499.
48 +
Wisniewski HM, Terry RD:  Reexamination of the pathogenesis of the senile plaque , in Zimmermann HM (ed): Progress in Neuropathology . New York, Grune & Stratton Inc, 1973;, vol 2, pp 1-26.
49 +
Wisniewski HM, Terry RD:  Neuropathology of the aging brain , in Terry RD, Gershon S (eds): Neurobiology of Aging . New York, Raven Press, 1976;, pp 265-280.
50 +
Hirano A, Zimmerman HM:  Alzheimer's neurofibrillary changes: A topographic study . Arch Neurol 1962;;7:227-242.
51 +
Wisniewski H, Terry RD, Hirano A:  Neurofibrillary pathology . J Neuropathol Exp Neurol 1970;;29:163-176.
52 +
Hirano A, Dembitzer HM, Kurland LT, et al:  The fine structure of some intraganglionic alterations . J Neuropathol Exp Neurol 1968;;27:167-182.
53 +
Tomlinson BE, Blessed G, Roth M:  Observations on the brains of nondemented old people . J Neurol Sci 1968;;7:331-356.
54 +
Wisniewski K, Jervis GA, Moretz RC, et al:  Alzheimer neurofibrillary tangles in diseases other than senile and presenile dementia . Ann Neurol 1979;;5:288-294.
55 +
Mandybur TI, Nagpaul AS, Pappas Z, et al:  Alzheimer neurofibrillary changes in subacute sclerosing panencephalitis . Ann Neurol 1977;;1:103-107.
56 +
Chou SM, Thompson HG:  Electron microscopy of storage cytosomes in Kufs' disease . Arch Neurol 1970;;23:489-501.
57 +
Hirano A, Malamud N, Elizan TS, et al:  Amyotrophic lateral sclerosis and parkinsonism-dementia complex on Guam . Arch Neurol 1966;;15:35-51.
58 +
Faden AI:  Myoclonus in Alzheimer disease . Arch Neurol 1976;;33:278-280.
59 +
Kidd M:  Alzheimer's disease: An electron microscopy study . Brain 1964;;87:307-327.
60 +
Terry RD, Gonatas NK, Weiss M:  Ultrastructural studies in Alzheimer's presenile dementia . Am J Pathol 1964;;44:269-297.
61 +
Wisniewski HM, Narang HK, Terry RD:  Neurofibrillary tangles of paired helical filaments . J Neurol Sci 1976;;27:173-181.
62 +
Schochet SS Jr, Lampert PN, McCormick WF:  Neurofibrillary tangles in patients with Down's syndrome: A light and electron microscopic study . Acta Neuropathol 1973;;23:342-346.
63 +
Hadfield MG, Martinez AJ, Gilmartin RC:  Progressive multifocal leukoencephalopathy with paramyxovirus-like structures, Hirano bodies and neurofibrillary tangles . Acta Neuropathol 1974;;27:277-288.
64 +
Horoupian DS, Yang SS:  Paired helical filaments in neurovisceral lipidosis (juvenile dystonic lipidosis) . Ann Neurol 1978;;4:404-411.
65 +
Tellez-Nagel I, Wisniewski HM:  Ultrastructure of neurofibrillary tangles in Steele-Richardson-Olszewski syndrome . Arch Neurol 1973;;29:324-327.
66 +
Rewcastle NB:  The 15 nm filament neurofibrillary tangle . Neuropathol Appl Neurobiol 1976;;2:490.
67 +
Tomonaga M:  Ultrastructure of neurofibrillary tangles in progressive supranuclear palsy . Acta Neuropathol 1977;;37:177-181.
68 +
Shibayama H, Kitoh J:  Electron microscopic structure of the Alzheimer's neurofibrillary changes in case of atypical senile dementia . Acta Neuropathol 1978;;41:229-234.
69 +
Yagishita S, Itoh Y, Amano N, et al:  Ultrastructure of neurofibrillary tangles in progressive supranuclear palsy . Acta Neuropathol 1979;;48:27-30.
70 +
Plobst A:  Degenerescence neurofibrillaire sous-corticale senile avec presence de tubule contournes et de filaments droits: Forme atypique de la paralysie supranuclear progressive . Rev Neurol 1977;;133:417-428.
71 +
Lampert P:  Fine structural changes of neurites in Alzheimer's disease . Acta Neuropathol , 1971;, (suppl 5) , pp 49-53.
72 +
Griffiths RI, Miller R:  Vascular permeability to protein and vasogenic edema in experimental concussive injuries to the canine spinal cord . J Neurol Sci 1974;;22:291-304.
73 +
Ishii T:  Enzyme histochemical studies of senile plaques and the plaque-like degeneration of arteries and capillaries . Acta Neuropathol 1969;;14:250-260.
74 +
Wisniewski HM, Johnson AB, Raine CS, et al:  Senile plaques and cerebral amyloidosis in aged dogs . Lab Invest 1970;;23:287-296.
75 +
Skalickova O, Jezkova Z, Slavickova V:  Immunological aspects of psychiatric gerontology . Rev Czech Med 1962;;8:264-275.
76 +
Ishii T, Hoga S:  Immuno-electronmicroscopic localization of immunoglobulins in senile plaques by means of fluorescent antibody techniques . Acta Neuropathol 1975;;32:157-162.
77 +
Wisniewski HM:  Possible viral etiology of neurofibrillary changes and neuritic plaques , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 555-558.
78 +
Johnson RT:  Viral etiology in amentias and dementias , in Katzman R (ed): Congenital and Acquired Cognitive Disorders . New York, Raven Press, 1979;, pp 177-187.
79 +
Scheinberg IH:  Toxicity of heavy metals to the central nervous system , in Katzman R, Terry RD, Bick KL (eds): Aging . New York, Raven Press, 1978;, vol 7: Alzheimer's Disease: Senile Dementia and Related Disorders, pp 487-491.

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To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
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Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
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