By Erna Christensen
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Additional info for Cerebral Palsy. A Clinical and Neuropathological Study
One of these (23) had a difficult delivery (caesarean section) and at the age of 4 months severe gastroenteritis, but brain autopsy revealed degeneration most likely due to perinatal anoxia. In case 50 the neuropathological changes were also degenerative. Perinatal aetiology was suspected in 10 patients. The mother of one of these (No. 48) also had a history of vaginal bleeding from the eighth month. In three cases there was forceps delivery and in one a caesarian section. Four had perinatal asphyxia and one was a precipitate delivery.
An air study showed diffuse dilatation of the ventricular system. The spasticity was symmetrical and very severe. He continued to develop very slowly. Frequent febrile episodes of unknown origin occurred, but he died of pneumonia. Brain autopsy: Brain weight after fixation 855 g. Macroscopic examination showed nothing abnormal in the right hemisphere, brain stem, or cerebellum, but the left hemisphere was partially transformed into a large cyst containing clear, thin fluid. The cyst extended from the back part of the left frontal lobe down into the temporal lobe and into the premotor and postmotor gyri as well as into the supra marginal and angular gyri.
This could also be seen in the thin rim of brain tissue in both parietal and occipital lobes. The scanty white matter showed a diffuse deficiency in myelin. 39 The degenerative changes appeared as diffuse cortical gliosis and satellitosis. The gliosis was most pronounced around the porencephalic area in the right hemisphere. The cyst was traversed by glial trabeculae. In all parts of both lentiform nuclei severe ganglion cell degeneration was present, and the ependymal cells on the ventricular walls were in many places replaced by granular astrocyte proliferation.
Cerebral Palsy. A Clinical and Neuropathological Study by Erna Christensen