<症例>18年の経過で精神, 神経症状を呈した水頭症の病理学的所見

概要

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An autopsy case of hydrocephalus with demyelination of the white matter and very mild cellular reaction is reported. A 45-year-old woman was found to be awake and speaking alone at midnight. Involuntary movements and gait disturbance gradually developed. Since the age of 62,she had become bedridden, saying few words, and suffered from incontinence. Brain CT scan showed remarkable ventricular dilatation. Her general condition gradually deteriorated, and she died at the age of 63. An autopsy revealed incomplete diffuse demyelination, axonal swelling and diminution of the centrum semiovale, and the subependymal white matter in a spongy state. Despite these morphological changes, severe proliferation of the glial fibers, astroglias, and fat laden macrophages were not observed. Definite neuronal loss and gliosis related to the clinical involuntary movements and gait disturbance were not found in the cortex, basal ganglia or brain stem. In addition, fibrous thickening of the arachnoid membrane could be seen at all levels of the spinal cord, most prominently at the cervical level. However, neither obvious stenosis nor obstruction of the cerebrospinal fluid pathway was evident. Therefore, the changes in the white matter were presumed to be caused by gradual circulatory disturbance of the cerebrospinal fluid. This disturbance may be a causative factor of the hydrocephalus.
近畿大学の論文
1987-09-25