Sevestre H, Vercken J B, Henin D, Duyckaerts C, Guillon F, Chaunu M P, Durand M C, Goulon M, Hauw J J
Service de Neuropathologie, Hôpital de la Salpêtrière, Paris.
Ann Med Interne (Paris). 1988;139(4):245-50.
Sixteen cases of anoxic encephalopathy in adult patients admitted to the intensive Care Department of Raymond Poincaré Hospital (Garches) have been selected on the following criteria: resuscitation by external cardiac massage for cardio-respiratory failure, without any previous history of anoxia and with detailed data on the subsequent evolution of neurological signs and symptoms. Main clinical features were compared to the results of the neuropathological examination. The pattern and the distribution of changes are detailed. The cerebral cortex was always involved by diffuse ischemic cell changes or by laminar necrosis. The Sommer's sector of Ammon's horn was affected in 15 cases, the basal ganglia in 14, the cerebellum in 11, the brain stem in 6. The very rarely mentionned necrotic brain stem changes, which involved inferior colliculi, periaqueductal gray matter and substantia nigra were sometimes associated with lesions of the floor of the IVth Ventricle and of the mamillary bodies. They were different from Wernicke's encephalopathy with could be dismissed on clinical and pathological grounds. No clinical signs or symptoms specific for this distribution of changes could be found by the retrospective study of the clinical files.
我们选取了雷蒙德·庞加莱医院（加歇）重症监护科收治的16例成年缺氧性脑病患者，选取标准如下：因心肺功能衰竭接受体外心脏按压复苏，此前无缺氧病史，且有神经体征和症状后续演变的详细数据。将主要临床特征与神经病理学检查结果进行了比较。详细说明了病变的模式和分布情况。大脑皮层总是出现弥漫性缺血性细胞改变或层状坏死。15例患者海马的索默氏区、14例基底神经节、11例小脑、6例脑干出现病变。非常罕见的脑干坏死性改变累及下丘、导水管周围灰质和黑质，有时与第四脑室底部和乳头体病变相关。这些改变与韦尼克脑病不同，可通过临床和病理依据排除。通过对临床病历的回顾性研究，未发现这种病变分布所特有的临床体征或症状。
