Bernard J. Alpers

Bio: Bernard J. Alpers is an academic researcher. The author has contributed to research in topics: Aneurysm & Circle of Willis. The author has an hindex of 25, co-authored 91 publications receiving 2463 citations.

Anatomical studies of the circle of Willis in normal brain.

Abstract: Introduction The present study was undertaken in order to determine the anatomical structures of the circle of Willis, 27 with the purpose of learning its normal configuration, the frequency of deficient or incomplete circles, and, if possible, how these findings can be correlated with the clinical problems of vascular disease, such as infarcts, aneurysms, and vascular anomalies. There are many problems in vascular disease of the brain which make desirable an intimate knowledge of variants in the anatomy of the circle of Willis. The state of the circle becomes important in determining the adequacy of the brain circulation in operations for cerebral aneurysm and in ligation of the carotid artery. The possibility of bypassing or shunting effects in occlusion of one of the cerebral vessels and the adequacy of recovery or lack of recovery after vascular occlusion might be explained in part by variations in the anatomy of the circle

Diffuse progressive degeneration of the gray matter of the cerebrum

Abstract: Knowledge of the pathology of numerous nervous disorders in infants is still in an insecure state. Save for a few diseases, little is known of the factors behind the production of organic nervous disease in infants. Every case studied from a pathologic standpoint is of interest because of the light it may throw on the neuropathology of these disorders. Consequently, the present case is reported as an addition to the knowledge of the pathology of the infantile brain. REPORT OF CASE1 Clinical History. —A girl, aged 3 months, was admitted to the Hamburg Sauglingsheim in Barmbeck. The parents were apparently normal. The mother, aged 30, was said to be nervous, and the father, aged 27, was healthy. The child was the first-born, and the birth was normal in every respect. During the first few weeks, development was normal. The patient took feedings regularly, first by breast and later artificially.

Massive cerebral hemorrhage. clinical and pathological correlations.

Abstract: The present study is a clinical and pathological analysis of 135 cases of spontaneous massive cerebral hemorrhage in which hemodynamic disorders, especially hypertension, constitute the significant etiologic factors. Massive cerebral hemorrhage is defined as those lesions at least 3 cm in largest dimension in the cerebral hemispheres or 1.5 cm in the brain stem, thus coinciding with Russell's definition.12Hemorrhages associated with injury, blood dyscrasias, and malformations have not been included in the basic study. Origins of Hemorrhage.— The hypertensive group formed 60% of a total of 225 autopsy proven, nontraumatic cerebral hemorrhages. Cerebral aneurysm was responsible for 20% and blood dyscrasias for 13%. The various conditions found in the present group of hemorrhages are shown in Table 1. Clinical Features Onset of the Strokes.— The onset of cerebral hemorrhage is usually sudden but may be gradual under special circumstances. In two thirds of the cases in this series

Circle of Willis in cerebral vascular disorders. The anatomical structure.

Abstract: Introduction There is great variability in the normal configuration of the circle of Willis (Alpers, Berry, Paddison).1Relatively little information is available concerning its structure in cerebral softening due to thrombosis and embolism and in cerebral hemorrhage and aneurysm. The present study was undertaken in order to determine the incidence and nature of the anomalies of the circle of Willis in the various forms of cerebral vascular disorder, particularly in occlusive vascular disease, where the factor of collateral circulation appears to have greater significance than in cerebral or meningeal hemorrhage. Material and Methods The basis of the present study is formed by 194 gross brain softenings. Of these 56 were found to be the result of thrombosis; 53 were due to embolism; and the cause of the softening was unidentified in 85 cases. The high incidence of an unidentified source is due to the fact that many of the

Tumors of rathke's cleft: (hitherto called tumors of rathke's pouch)

Abstract: The nomenclature of pituitary and parapituitary lesions needs revision. In the first place, the term pituitary should be accepted and that of hypophysis discarded, orvice versa. Since the term pituitary, derived from the rootpituita, or phlegm, was adopted by the ancients because the structure was believed to supply the mucous secretion to the nasal membrane, we suggest abandoning it and accepting the alternate term hypophysis. There is general acceptance of the terms applied to the component parts of the hypophysis, namely, the pars anterior, pars intermedia and pars posterior, although Tilney proposed that the pars anterior be called the pituitary gland and the pars posterior (the neural lobe) the processus infundibuli. However, this communication does not concern the hypophysis itself but the parahypophyseal lesions, which are commonly called tumors of Rathke's pouch and craniopharyngeal tumors or craniopharyngiomas. But these last two terms, as Tilney says,1are unquestionably

Spontaneous intracerebral hemorrhage.

Abstract: Nontraumatic intracerebral hemorrhage is bleeding into the parenchyma of the brain that may extend into the ventricles and, in rare cases, the subarachnoid space. Each year, approximately 37,000 to 52,400 people in the United States have an intracerebral hemorrhage.1,2 This rate is expected to double during the next 50 years as a result of the increasing age of the population and changes in racial demographics. Intracerebral hemorrhage accounts for 10 to 15 percent of all cases of stroke and is associated with the highest mortality rate, with only 38 percent of affected patients surviving the first year.3 Depending on . . .

Management of Stroke in Infants and Children A Scientific Statement From a Special Writing Group of the American Heart Association Stroke Council and the Council on Cardiovascular Disease in the Young

Abstract: Purpose— The purpose of this statement is to review the literature on childhood stroke and to provide recommendations for optimal diagnosis and treatment. This statement is intended for physicians ...

Screening for dementia with the Memory Impairment Screen

Abstract: Objectives: To validate a sensitive and specific screening test for AD and other dementias, assess its reliability and discriminative validity, and present normative data for its use in various applied settings. Background: To improve discrimination in screening for AD and dementia, we developed the Memory Impairment Screen (MIS), a 4-minute, four-item, delayed free- and cued-recall test of memory impairment. The MIS uses controlled learning to ensure attention, induce specific semantic processing, and optimize encoding specificity to improve detection of dementia. Methods: Equivalent forms of the MIS were given at the beginning and end of the testing session to assess alternate forms reliability. Discriminative validity was assessed in a criterion sample of 483 aged individuals, 50 of whom had dementia according to Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised) criteria. Results: The MIS had good alternate forms reliability, high construct validity for memory impairment, and good discriminative validity in terms of sensitivity, specificity, and positive predictive value. We present normative data for use in settings with different base rates (prevalences) of AD and dementia. Conclusion: The MIS provides efficient, reliable, and valid screening for AD and other dementias.

A review of hemoglobin and the pathogenesis of cerebral vasospasm.

Abstract: We believe that current experimental and clinical evidence can be most satisfactorily interpreted by assuming that oxyhemoglobin is the cause of cerebral vasospasm that follows subarachnoid hemorrhage. We review the pathogenetic mechanisms by which oxyhemoglobin affects cerebral arteries. The relative importance of each of these mechanisms in the genesis of vasospasm, the biochemical pathways of oxyhemoglobin-induced smooth muscle contraction, and the intracellular actions of oxyhemoglobin on smooth muscle and on other cells in arteries are still not definitely established.