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器质性脑综合征的形态学方面(作者译)

[Morphological aspects of organic brain syndromes (author's transl)].

作者信息

Jellinger K

出版信息

Wien Klin Wochenschr. 1975 Apr 4;87(7):229-34.

PMID:180699
Abstract

Organic psychoses are caused by a variety of disorders. In general, they are due to diffuse dysfunction of the brain without any specific anatomical basis, but they may be modified by disorders of some distinct neuronal systems as a result of local accentuation of a dissuse morbid process or localized brain damage. Acute organic psychoses are usually caused by disorders of the blood-brain barrier (cerebral oedema), acute neuronal dysfunction of disorders of synaptic transmission. Acute lesions may be reversible or terminate in stationary defective states or progressive neuronal degeneration. In late stages, the anatomical sequelae of the basic process and of secondary lesions are hardly to be separated. The non-specificity and inconsistency of brain lesions is demonstrated in chronic alcoholic psychoses. In senile organic psychoses there are quantitative correlations between psychopathological, neurophysiological (slowing of the basic rhythm) and morphological changes, mainly characterized by loss of neurons and synaptic contacts. Vascular syndromes are often over-diagnosed clinically. Localized mental syndromes are non-specific, but show characteristic locations, as they are commonly associated with dysfunction of neuronal systems engaged in storing and recall of information (frontobasal region and limbic system). Further detailed studies are needed in order to achieve better correlation between specific features of behavioural and intellectual defects and anatomical location and quantitiy of lesions.

摘要

器质性精神病由多种病症引起。一般来说,它们是由于大脑的弥漫性功能障碍,没有任何特定的解剖学基础,但它们可能因某些不同神经元系统的紊乱而发生改变,这是由于废用性病理过程的局部加重或局部脑损伤所致。急性器质性精神病通常由血脑屏障紊乱(脑水肿)、突触传递障碍的急性神经元功能障碍引起。急性病变可能是可逆的,或终止于静止的缺陷状态或进行性神经元变性。在后期,基本过程和继发性病变的解剖学后遗症很难区分。慢性酒精性精神病中脑损伤的非特异性和不一致性得到了证明。在老年器质性精神病中,心理病理学、神经生理学(基本节律减慢)和形态学变化之间存在定量相关性,主要表现为神经元和突触联系的丧失。血管综合征在临床上常常被过度诊断。局限性精神综合征是非特异性的,但显示出特征性的部位,因为它们通常与参与信息存储和回忆的神经元系统功能障碍有关(额基底区域和边缘系统)。为了使行为和智力缺陷的具体特征与病变的解剖位置和数量之间有更好的相关性,还需要进一步详细研究。

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