Cerebral paradoxical embolism has not until now been described as a cause of cryptogenic stroke in newborn infants. A male infant was born at 27 weeks 2 days' gestational age by emergency Caesarean section in a twin pregnancy because of intrauterine growth retardation and absence of diastolic flow in the twin. His birthweight was 950g (50th centile). Apgar scores were 7 and 8 at 1 and 5 minutes respectively. At 17 days of life he showed sudden respiratory distress and signs of encephalopathy. Presence of deep venous thrombosis, patent foramen ovale (PFO), and clinical progression suggested paradoxical embolism which were confirmed by neuroradiological findings. The high incidence of PFO and central venous catheter-related deep venous thrombosis in newborn infants suggest that paradoxical embolism is probably a more common complication than has been thought.

The Human Tissue Bill is now before the UK Parliament. We await the outcome and the codes of practice that will be drawn up following the deliberations of our politicians. The Bill is based upon proposals made by the Retained Organs Commission and the Department of Health following some three years of consultation. The proposals are wide ranging, encompassing retention of tissues removed at surgery as well as autopsy material. Among the proposals are the establishment of a human tissue authority to oversee the use of human tissue, the creation of new offences related to tissue retention, recommendations regarding the use or disposal of ‘unclaimed or unidentifiable human organs and tissue’ and, perhaps most important, the requirement for explicit consent from bereaved families for the use of organs and tissues. The proposals of the Human Tissue Bill are important and far-reaching and have huge implications for the future practice of pathology, for research, and for our understanding of disease, particularly diseases of the nervous system. However, will this Bill do anything to reverse the collapse of autopsy pathology as the benchmark for clinical medicine?

Giant axonal neuropathy (GAN) is a chronic progressive disease of the peripheral nervous system, but lesions can also occur in the central nervous system (CNS), especially in the brainstem and cerebellum. Its mode of inheritance is autosomal recessive, with parents of affected children often being consanguineous, but sporadic cases have been reported.