[Ultrastructural aspects of the secondary brain stem syndrome in hemorrhages and infarcts in the cerebral hemispheres].

Ultrastructural aspects of the secondary brain stem syndrome in patients with hemorrhages and infarcts in the brain hemispheres are considered. The secondary brain stem syndrome is manifested by diverse clinical symptomatology suggestive of dysfunction of different levels of the brain stem: a diminished level of awakening, oculomotor disturbances, changes in the muscle tone and reflexes, cardiorespiratory and other vegetative disorders. Examining the reticular formation of the brain stem under the electron microscope the authors revealed changes in neurons in the form of chromatolysis, an increase in the cellular cytoplasm of the number of lipid inclusions and lysosomes, swelling of mitochondria and (less frequently) the appearance of cells with an elevated osmiophilia of the cytoplasm. Also observed was a systemic increase in lysosomes and lipid granules in capillary structures, and in glial and nervous cells. The pathogenetic factors of secondary brain stem syndrome are discussed.