Anatomopathological study of dementia syndrome linked with an abnormal cerebrospinal fluid flow. Report of literature and personal observations.
The authors have analysed the data of the literature to identify the cases of normotensive hydrocephalus that underwent surgery and then died after the operation; some of these patients died over varying periods of time after the operation and the death was due to accidents. It seems that the anatomopathological lesions are less important in cases that benefited from the operation compared with cases that did not present perceptable clinical variations. The authors report the anatomopathological data of four personal cases which, from the clinical point of view, presented the dementia symptom associated in varying degrees to other neurological symptoms such as disturbances of the gait and of the sphincters functions (Adams' triad). All four subjects presented dilatation of the cerebral ventricles without cortical atrophy. From the histological point of view, there was: exfoliation of the ependyma, subependymal gliosis, demyelination of the white periventricular matter and spongiosis; there were no lesions of the meninges, of the cerebral cortex, no vascular alterations, except for those due to age, or stenosis of the aqueduct. The cause of the ventricular dilatation that was responsible for the clinical symptoms was not clear from the histological examination; the value and the significance of the histopathological data obtained and from the data available from the review of the literature are discussed and they point out the fact that many of the lesions encountered seem to be the consequence rather than the cause of the hydrocephalus.(ABSTRACT TRUNCATED AT 250 WORDS)
Neurologic Clinic of Genoa University, Italy.
G
G
Brusa
A
A
Piccardo
N
N
Pizio
C
C
Gambini
D000368:Aged; D001921:Brain / Q000473:pathology*; D003704:Dementia / Q000209:etiology / Q000473:pathology*; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications* / Q000473:pathology