So far, the authors have found it rare to have the final diagnosis be an unexpected degenerative disease. Neurosurgeons may be asked by neurologists to perform a biopsy for suspected neuronal storage diseases and leukodystrophies of different types, Creutzfeld-Jakob disease (CJD), Alzheimer's disease and Pick's disease, as well as for patients who show progressive deteriora tion that cannot be characterized clinically. The location and amount of the specimen may be critical but we generally recommend a good cubic centimeter of cortex and white matter so that adequate blocks for frozen and paraffin sections and electron microscopy can be performed. Unfortunately, often only non-specific gliotic tissue is obtained in these cases and the disease remains frustratingly undetectable.
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