Cerebrale Kinderlähmung

Histopathologic Brain Changes in 1152 Cases of the Perinatal and Early Infancy Period

“…The historic term 'congenital encephalitis of Virchow' has been redefined as a non-inflammatory necrosis in die periventricular white matter, conditioned by various factors incident to birth [1,13,15,16]. The more recently introduced term 'peri ventricular leucomalacia' [18] is in principal identical with the peri ventricular necrosis of Schwartz [12,15] and Siegmund [13] and with the edema-necrosis of H allervorden and Meyer [2] and of Veith [17].…”

“…Based on the studies of W in d l e and B e c k e r [30] on experimentally produced neonatal asphyxia in guinea pigs, H a l l e r v o r d e n and M ey er [2] stated that the fetal brain, less differentiated in function and structure than in childhood and adult life, has a greater tolerance against hypoxia. However, results obtained in experimentally pro duced anoxia of laboratory animals, in their premature or neonatal state [30,31,32,33,34,35,36,37], are in no way applicable to our findings of the different incidence of hypoxic cortical changes be tween premature and fullterm as observed in a variety of disease conditions of the perinatal and early infancy period.…”

“…The étiologie complexity of cerebral palsy has been recognized for some time [1,2]. More recently [3], it has been pointed out that prognosis in infants surviving obvious perinatal accidents is frequently uncertain; that even after severe disturbances within the immediate postnatal era, infants later in life have shown no abnormalities; or, vice versa, that serious neurological disorders were observed after relatively short periods of perinatal irritation.…”

Lésions cérébrales dues à Phypoxie périnatale

“…En effet, selon liossle [16] les processus cicatriciels et les réactions inflammatoires n'apparaissent que tardivem ent, ces dernières vers le 6-7e mois. A terme, les structures du tronc cérébral et de la moelle ont acquis des possibilités de réaction très proches de celles des structures équiva lentes de l'adulte, alors que le télencéphalc est encore incapable de résister à une aggression, il peut être détruit et disparaître ainsi com plètement [9].…”

“…Dans les cas où la survie a été possible, l'écorce peut présenter [9,10,12] un état spongieux dû en particulier à la disparition des neu rones des couches III et V; lorsque l'atteinte est très marquée, il ne subsiste qu'un réseau de fibrilles gliales entre les mailles duquel les neurones ainsi que la myéline ont complètement disparu. A l'examen externe les circonvolutions sont amincies, irrégulières, de consistance souvent plus ferme, recouvertes de lcptoméninges un peu épaissies, on parle alors d'ulégyries ( fig.…”