Neuropatologia polska最新文献

The influence of intensive chronic intoxication with ethanol on adult Wistar rats was investigated. The animals received through a stomach pump 5 ml of 40% ethyl alcohol solution daily for three months. Structural lesions of the CNS observed in the light microscope consisted of acute and chronic edematous changes with infiltration of mononuclear cells and presence of lymphocytic-microglial nodules and myelin discoloration. Sclerotization of nerve cells with reactive gliosis was also noted in the CA1 sector of ventral hippocampus. The pattern of changes is comparable with the most frequently observed pathological abnormalities observed in the CNS of humans after alcohol abuse.

The paper comprises 70 cases of extensive supratentorial infarctions. The topography and structure of secondary lesions occurring in the region of herniation and displacements caused by the coexisting brain edema were analysed. The extent of edema served as criterion in the division of the material into three groups in dependence on the occurrence of herniations and displacements. Most frequent was herniation of hippocampal uncus and most rare that of the cerebellar vermis. In group I showing no herniations selective necrosis was noted of neurons particularly sensitive to ischemia and anoxia, especially in Sommer's sector of the hippocampus. In group II secondary necrosis was visible in the regions of herniae, and in the group III also in the translocated deep brain structures in the hemisphere contralateral to the infarct and in the brain stem where, moreover, secondary hemorrhages were present. Supratentorial secondary hemorrhages were less frequent. They were noted in the thalamus both on the side of the infarct and in the contralateral hemisphere. Supratentorial necroses were more frequent. Their intensity varied from selective necrosis to Jacob's edematous necrosis. Severe displacement of deep structures and of the brain stem was associated with development of secondary internal hydrocephalus, especially in the hemisphere contralateral to the herniation. To the most important pathogenetic factors causing development of secondary morphological lesions belong disturbances of blood supply occurring as the result of pressure differences between the supra- and infratentorial space, resulting from pressure and displacement of arterial vessels, damage of their walls and distrubances of venous flow and also development of secondary internal hydrocephalus. Extensive necroses and hemorrhages increase the area of primary necrosis. Lesions resulting from herniation, displacement and compression of vessels were superposed on the picture of brain edema both present or passed. Secondary necroses damaging bilaterally structures belonging to the limbic system and reticular formation may be an additional factor in the development of edematous encephalopathy and the development of a psychoorganic syndrome after stroke.

The here presented case concerns a 74-year-old woman treated for many years with steroids and immunosuppressive drugs during pancytopenia. Seven days before her death she developed severe headaches and visual disorders, rapidly increasing disturbances of consciousness and a temperature of 40 degrees C. The course of the disease was violent with meningeal syndrome and cerebral coma. The cerebrospinal fluid was purulent, pleocytosis 1235/ml, with prevalence of polymorphonuclear leucocytes (88%) and an protein level increased to 210 mg%. In autopsy no mycotic changes were found in the internal organs whereas in microscopic examination of the brain the dominant finding was the presence of numerous filamentous bodies with septa characteristic of aspergillus which were visible both in microthrombi in the lumen of meningeal and interstitial vessels and in the areas of extensive necroses in both cerebral hemispheres and the brain stem as well as within granulomas occurring on the edges of necrotic foci and in the inflammatory infiltration of the brain base meninges. The presence of aspergillus hyphae was usually associated with a severe inflammatory reaction of polymorphonuclear leucocytes, acidophilic and plasmatic cells in microabscesses and in the inflammatory infiltration of meninges or in the form of granulomas composed mainly of multinucleated giant cells of Langhans or of foreign body type and mononuclear cells. The etiopathogenesis of these changes is discussed. The role of the facilitating factor could have been played by protracted therapy with steroids and immunosuppressive drugs and/or by pancytopenia itself which is probably associated with abnormal immunological response. Noteworthy is the fact that the seldom described mycotic changes caused by aspergillus concerned in the present case the central nervous system exclusively.

The aim of this work was to elucidate the postischemic changes appearing in hypothalamic secretory nuclei (n. supraopticus and n. paraventricularis) and neurohypophysis in rats which underwent the incident of clinical death. The ultrastructural organization of secretory neurons and their axons in the neurohypophysis was investigated two weeks and one month after the insult. SO and PV neurons showed an increased number of polymorphic lysosomes, lipid droplets as well as an abundance of cytoskeleton elements, i.e., neurotubules and neurofilaments. Some astrocytic processes in the neuropil were swollen. Synaptic endings on SO and PV neurons had a normal ultrastructure. An increased number of lysosomes and dense bodies was observed in some axons and pituicytes in the neurohypophysis.

Shared antigenic structures between the nervous and immune systems are described. Some of them like Thy-1 are known from many years, some, like leukosialin were recently found. Possible role of these molecules is discussed.