[A neuropathological study on respirator brain].
A neuropathological study was conducted on 101 respirator brains. The patients comprised 62 men and 39 women, ranging in age from 11 to 84 years, the average being 49.4 years. Of these, 51 cases died of cerebrovascular disease, including 26 cases of subarachnoid hemorrhage. The average duration of mechanical supportive care was 99 hours. The mean weight of the brain at autopsy was 1,460 g. Characteristic pathological findings were brain edema, congestion, herniation and various subarachnoid hemorrhages. Brain consistency was soft despite adequate fixation. Histologically, the cytoplasm of neurons in the cerebral cortex, basal ganglia, cerebellum and brain stem was pale and ghost like. In the white matter, myelin staining was quite pale and nuclei of the glial cells were shrunken and piknotic. Autolysis of the granular layer of the cerebellar cortex and necrosis of anterior parts of the pituitary gland were evident in all of the brains examined. There were no reactive astrocytosis and no infiltration neutrophils in the superficial areas of the cerebrum and brain stem, possibly due to temporary or partial circulation. There exists some correlation between the degree of autolysis and the duration of artificial aeration. But no relationship between the former and the basic disease was found. In the respirator brains, autolysis was most prominent in the cerebral cortex, thalamus, tegmentum of the brain stem, granular layer of the cerebellar cortex and the pituitary gland. It was possible to establish the diagnoses of underlying diseases such as cerebrovascular disease, meningoencephalitis, tumor and degenerative disease in the majority of cases through neuropathological analysis on the respiratory brains.(ABSTRACT TRUNCATED AT 250 WORDS)
Ujihira
N
N
Department of Neurology, Nagoya University School of Medicine.
Hashizume
Y
Y
Takahashi
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001329:Autolysis; D001921:Brain / Q000473:pathology*; D002648:Child; D005260:Female; D006323:Heart Arrest / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial; D013997:Time Factors