ABSTRACT
Realizou-se o estudo das lesoes encefálicas em 120 vítimas fatais de acidente de trânsito, tendo-se verificado baixa sobrevida média e alta freqüência de lesoes cranioencefálicas e extracraniais. Relativamente às casuísticas análogas referentes a traumas cranianos fechados de diferentes origens, observou-se baixa freqüência de lesoes primárias focais (fratura de crânio, contusao cerebral e hematomas intracranianos) e alta de lesoes primárias difusas (lesao axonal difusa e lesao vascular focal múltipla). A lesao axonal difusa (LAD) foi encontrada em 75,8 por cento dos encéfalos, sendo do primeiro grau em 17,6 por cento; do segundo grau em 53,8 por cento; e, do terceiro, em 28,6 por cento. Apesar da distribuiçao difusa que caracteriza esta lesao, ocorreu comprometimento preferencial das formaçoes inter-hemisféricas e da porçao rostral do tronco encefálico, geralmente de forma lateralizada.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Accidents, Traffic , Brain Injuries/pathology , Brain Injuries/epidemiologyABSTRACT
A post-mortem examined case of herpetic brainstem encephalitis is presented. Clinically, the patient had cephalalgia followed by ataxia, drowsiness and multiple palsies of some cranial nerves, developing into death in eight days. The pathologic examination of the brain showed necrotizing encephalitis in multiple foci limited to the brainstem, more distinctly in the pons and medulla oblongata. The technique of immunoperoxidase revealed rare glial cells with intranuclear immunoreactivity for herpes antigen. Rare viral particles with the morphological characteristics of the herpesvirus were identified in the nuclei of neurons in 10% formol fixed material. This is the second reported case of herpetic brainstem encephalitis confirmed by post-mortem examination. The pathway used by the virus to reach the central nervous system and its posterior dissemination to the oral cavity, the orbitofrontal region and the temporal lobes as well as to the brainstem, after a period of latency and reactivation, are discussed.
Subject(s)
Brain Stem , Encephalitis/pathology , Herpes Simplex/pathology , Adult , Encephalitis/etiology , Humans , Immunoenzyme Techniques , Male , Simplexvirus/pathogenicityABSTRACT
The pathological systematized study of the brain of 31 cases of the chronic cardiac form of Chagas' disease was undertaken. Elective parenchymatous necrosis was found in 64.5% of cases, mainly in cerebellar Purkinje cells, and in thalamic nuclei. Also found were multiple foci of old micronecrosis (51.6%) mostly in the cerebral cortex, old cerebral infarcts (22.6%), cortical laminar necrosis (16.1%) and cerebral cortical atrophy (3.2%). These findings are not specific and can be explained by thromboembolic phenomena and hypoxemia following from congestive heart failure and disturbances of the cardiac rhythm.
Subject(s)
Brain Ischemia/pathology , Brain/pathology , Cerebral Infarction/pathology , Chagas Cardiomyopathy/complications , Adult , Aged , Brain Ischemia/etiology , Cerebral Infarction/etiology , Female , Humans , Male , Middle Aged , NecrosisABSTRACT
Fez-se o estudo anatomopatologico sistematizado do encefalo de 31 casos da forma cronica cardiaca da doenca de Chagas. Encontrou-se necrose parenquimatosa eletiva em 64,5% dos casos afetando principalmente as celulas de Purkinje do cerebelo e alguns nucleos talamicos,focos multiplos de micronecrose antiga (51,6%) especialmente do cortex cerebral, enfartes cerebrais antigos (22,6%), necrose cortical em faixa (16,1%) e atrofia cortical cerebral(3,2%).Estes achados sao inespecificos e podem ser explicados em funcao de fenomenos trombo-embolicos e de hipoxemia decorrente de insuficiecia cardiovascular bem como de disturbios do ritmo cardiaco
Subject(s)
Adult , Middle Aged , Humans , Male , Female , Brain Ischemia , Chagas CardiomyopathyABSTRACT
Faz-se revisao dos principais aspectos da constituicao e funcoes do sistema integrador-adaptativo limbico-hipotalamico, destacando-se a participacao na determincacao do comportamento sexual, na regulacao do comportamento emocional e nas funcoes cognitivas. Exemplifica-se, ainda, adaptacoes mediadas por este sistema
Subject(s)
Humans , Central Nervous System , Hypothalamo-Hypophyseal System , Limbic System , Sexual BehaviorABSTRACT
A retrospective analysis of 19.760 consecutive autopsies and 72.972 biopsies in a period of over 41 years disclosed 24 intracranial tuberculomas in 17 patients, representing 4,2% of the intracranial space-occupying lesions. Most intracranial tuberculomas were found the cerebral hemispheres whereas one third of them were located in the cerebellum. About two thirds of the patients were younger than 20 years old. The clinical picture of intracranial tuberculomas is similar to that of other space-occupying lesions, comprising signs of raised intracranial pressure and signs related to the anatomical site of the lesion.
Subject(s)
Brain Diseases/pathology , Tuberculoma/pathology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Intracranial Pressure , Male , Middle Aged , Tuberculoma/complications , Tuberculosis, Meningeal/complications , Tuberculosis, Pulmonary/complicationsABSTRACT
Vinte e quatro tuberculomas intracranianos foram encontrados em 17 pacientes numa analise retrospectiva de 19.760 autopsias e 72.972 biopsias consecutivas, num periodo de 41 anos e 4 meses. Os 17 pacientes representaram 4,2% dos casos das lesoes expansivas intracranianas. A maioria dos tuberculomas se localizava nos hemisferios cerebrais, e um terco deles, no cerebelo. Cerca de 65% dos pacientes tinham idade inferior a 20 anos. O quadro clinico e semelhante ao das outras lesoes expansivas intracranianas estando relacionado a hipertensao intracraniana e a localizacao da lesao. Os dados encontrados sao comparados aos das varias series publicadas em diferentes paises
