Goertchen R, Wiedersberg H
Zentralbl Allg Pathol. 1976;120(1):34-44.
From the autopsies of one year 47 brains (10 stillborns, 28 prematures and 9 newborns) were systematically examined for hypoxemic cerebral lesions. In contrast to literature findings in 75% of the cases not only veins but also arteries showed congestions and a cerebral edema due to disturbances of circulation and permeability, predominantly caused by hypoxia. Nearly half of the cases had primary leptomeningeal hemorrhages and hemorrhages in the germinal matrix tissue; stillborns had no hemorrhages in the germinal matrix. Encephalodystrophic foci were found in 17% of the cases examined. 41 of 47 brains showed single nerve cell damage with cytolysis and 8 ones a focal nerve cell decay, especially localized in the brain-stem. They were observed equally frequent in stillborne, newborns and prematures. The polyetiologic cerebral lesions point out that birth trauma does not play the dominating role in the etiology as hitherto supposed. Hypoxia gets an increasing importance. Frequently birth traumatic and hypoxemic cerebral lesions are associated.
在一年中，对47例大脑（10例死产儿、28例早产儿和9例新生儿）进行尸检，系统检查缺氧性脑损伤情况。与文献报道结果不同，75%的病例中不仅静脉而且动脉都出现充血以及因循环和通透性障碍导致的脑水肿，主要由缺氧引起。近一半病例有原发性软脑膜出血和生发基质组织出血；死产儿生发基质无出血。在所检查的病例中，17%发现脑发育不良灶。47例大脑中有41例显示单个神经细胞损伤伴细胞溶解，8例有局灶性神经细胞坏死，尤其位于脑干。在死产儿、新生儿和早产儿中观察到的频率相同。多病因性脑损伤表明，出生创伤在病因学中并不像迄今所认为的那样起主导作用。缺氧的重要性日益增加。出生创伤性和缺氧性脑损伤常相伴出现。
