肝脳疾患の臨床病理学的研究 : 意識障害及び振戦の病因についての考察(<特集>脳と神経の研究II)

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概要

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• 1) The author studied clinico-pathologically seven autopsy cases of hepatocerebral disease, including both specific type (Inose) and pseudoulegyric type. The cases were clinically classified as follows : 1. cerebral type, presenting only neuropsychiatric symptoms ; 2. cerebro-hepatic type, beginning with neuropsychiatric symptoms, later accompanied by liver symptoms ; 3. cerebro-hepatic simultaneity type, developing with both symptoms at the same time ; 4. hepato-cerebral type, beginning with liver symptoms, later followed by neuropsychiatric symptoms; 5. hepatic type, presenting nothing except liver symptoms. Regarding the relationship of the mode of onset and prognosis, the cases in which liver symptoms were prodromous, showed a more rapid course, while the other cases in which neuropsychiatric symptoms were prodromous, were comparatively slow in their course. 2) From the neuropathological examinations, the author concluded that the clouding of consciousness during the course of hepatocerebral disease was due to pathological changes of the reticular formation in the brain stem ; while in one case of the pseudoulegyric type, due to the vascular changes of the cerebral cortices. 3) The genesis of tremor in the hepatocerebral disease may be concerned with the pathological changes of basal ganglia, especially of globus pallidus and putamen. 4) From the histopathologic findings of the brain, the following was suggested : the irreversibility of the neuropsychiatric symptoms resulted from histological damage of brain tissues, i.e., various degenerations of nerve cells, spongy states of ground substances, glial. degeneration, demyelinating changes, alteration of vascular walls, etc., which were presumably caused by abnormal metabolic agents due to liver disturbances.

• 千葉大学の論文
• 1965-11-28

著者

• 矢崎 光保

  総武病院

• 矢崎 光保

  干葉大学医学部神経精神医学教室

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