File of histopathological evaluation of nervous system diseases (1965) - nr 37/65

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Title: File of histopathological evaluation of nervous system diseases (1965) - nr 37/65

Abstract:

Histological diagnosis: Encephalomalacia rubra gyri temporalis super sin. cum meningitis reativi. Encephalopathia arteriosclerotica. Autopsy examination of 66-year-old patient was performed. Neuropathological evaluation in light microscopy was based on brain paraffin sections stained with H-E, cresyl-violet and Van Gieson's method.A focus of fresh incomplete necrosis, involving the white matter, was found in the left superior temporal gyrus and the adjacent part of the medial gyrus. The focus was characterized by severe cellular loss and the remaining elements were damaged - features of ischemic disorders, nerve cell disintegration and regressive changes in astroglium were observed. Loosely scattered single magrophages and leukocytes were seen throughout the necrotic area. In the cortex, numerous perivascular hemorrhages with massive leukocytic infiltration were found. Vascular endothelium was stimulated and proliferated, plasmocytes were present near the vessels. In the subdural space above the focus, severe mesodermal reaction with a profuse infiltrate of plasma cells, histiocytes, leukocytes, and macrophages was seen, and in other areas a reaction of lymphocytic cells and macrophages, a multiplication of fibroblasts, appendage cells, and an increase in connective tissue fibers occurred. Throughout the brain, large degree of atherosclerotic vascular changes, with predominantly fibrous changes in the cortical vessels and more advanced vitreous-fibrous changes in the white matter were seen. Around the altered vessels, small sinuses were often found in the white matter with the presence of single macrophages with hemosiderin, free hemosiderin deposits, or symptomatic infiltrates composed of small, round cells. In the white matter of the frontal lobe, a larger, organized, post-infarct cavity surrounded by fibrous glial tissue, and gemistiocytes was present and cluster of macrophages was visible. In the frontal and occipital cortex, diffuse cellular loss was observed, locally obliterating the layering of the cortex. Multiple forms of cellular disorders, mostly of the chronic type were observed. Depletion of dentate nucleus cells and Purkinje cells in the cerebellum was also evident. There were significant features of congestion and edema throughout the whole brain.