Topography of Lesions in Newborn and Infant Brains following Cardiac Arrest and Resuscitation

Abstract

The brain lesions produced by temporary arrest of circulation in a newborn and an 11-month-old infant are described. In the newborn, two periods of arrest occurred, one on the fifth day after birth and the second a few days before death on the sixth week. The older infant suffered a single episode of cardiac arrest at the age of 11 months and survived 8 days. In both cases, postmortem examination revealed lesions in spinal cord, in brain stem, and in cerebral hemispheres. This distribution of damage is compared with the patterns of injury produced experimentally by episodes of partial (hypoxia) and total (anoxia) asphyxia in subhuman primates. The coexistence of hemispheral and brain stem nuclear patterns of pathology indicates that both hypoxia and anoxia had occurred in the present cases.

Möbius sequence in children exposed in utero to misoprostol: Neuropathological study of three cases

“…Similar lesions in the brainstem have been identified in children suffering from cardiac arrest (Gilles, 1963;Dambska et al, 1976;Janzer and Friede, 1980), transient circulatory arrest, and asphyxia (Schneider et al, 1975;Leech et al, 1977). The intensity and distribution of the lesions varied.…”

Massive Brain Stem Necrosis in the Human Neonate: Presentation of Three Cases With Review of the Literature

“…Possibilities include (1) hypotension superimposed on watershed areas, (2) hypotension in combination with cerebral swelling, and (3) selective vulnerability of specific nuclei or areas of the brain.5-8 Azzarelli and coworkers have suggested that areas with a more advanced degree of morphological and biochemical maturation are the sites most susceptible to such damage. 2,12 Myers, 13 utilizing primates, clearly and specifically defined functional models for the production of each of the major patterns of injury that the newborn brain may sustain.…”

Solitary Tract Nuclei in Acute Heart Failure

“…Thus, it could represent the "most distant field" in the medullary tegmentum according to the theory of Optitz and Schneider. 40 However, in prior studies in animals 24 -26 and humans, 9,[11][12][13]16,21,22,27,29 extensive ischemic changes were described in many brain stem nuclei after an episode of acute heart failure, hypotension, or both. The involvement of the solitary tract nucleus, always associated with lesions of other medullary and pontine nuclei, was reported in few cases, 15,19,28,30 and the histological findings corresponded to infarcts of various timing.…”