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Joseph F. Cusick, Khang-Cheng Ho and Jay F. Schamberg

✓ Subarachnoid hemorrhage is a frequent finding in patients who have incurred neurological complications following chymopapain chemonucleolysis, but the basis for this occurrence remains controversial. The authors report the clinical and postmortem findings in a 42-year-old man who died 5 days after chemonucleolysis at the L4–5 and L5–S1 disc spaces. The predominant histological abnormality was a severe inflammatory arteritis of a medium-sized artery at the upper cervical level with disruption of the vessel wall. The potential causative role of chymopapain in this situation and the correlation of a vascular basis for many of the complications found after inadvertent intrathecal chymopapain injection are discussed.

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Joseph F. Cusick, Khang-Cheng Ho, Thad C. Hagen and Larry E. Kun

✓ Granular-cell pituicytomas of the neurohypophysis have a controversial histogenesis and oncological behavior. The occurrence of such a tumor in a patient whose father and daughter had endocrine neoplasms suggests a neuroectodermal origin for these tumors. Although all of the conditions considered in this report are unusual clinical entities, their correlation offers considerations in understanding the importance of genetic factors in tumor development.