[Autopsy case of hypoglycemic coma in a young diabetic woman with mental and somatic retardation (Prader-Labhart-Willi syndrome)]

A neuropathological study of a case of the Prader-Willi syndrome with an interstitial deletion of the proximal long arm of chromosome 15

An autopsy case, a 6-month-old girl, with an interstitial deletion of the long arm of chromosome 15;del(15)(q11.1q12) was reported. Muscle hypotonia, poor sucking and intermittent ocular deviation were noticed soon after birth. She also exhibited external features peculiar to the Prader-Willi syndrome (PWS). The muscle hypotonia persisted and head control was not achieved. She died at the age of 6 months due to bronchopneumonia. G-banding analysis of prometaphase chromosomes revealed a deletion of chromosome 15. Bronchopneumonia of the lungs and fatty metamorphosis of the liver were found. Neuropathological anomalies recognized were; disturbed undulating structures, resembling cortical micropolygyria and pachygyria, in the dentate nucleus and the inferior olivary nucleus, grumose degeneration of the nerve cells in the dentate nucleus, and heterotopia of middle-sized neurons in the cerebellar white matter. No abnormalities were observed in the hypothalamus-pituitary system. In some autopsy cases of PWS, cerebellar lesions have been reported. These might be related to the muscle hypotonia in PWS.

Perisulcal infarcts: lesions caused by hypotension during increased intracranial pressure

A pattern of cortical necrosis surrounding the cerebral sulci and similar to ulegyria was found in 5 patients. The lesions were widely disseminated in all parts of the hemispheric cortex, affecting mostly the deep cortex of several adjacent sulci. They were hemorrhagic in 3 patients, ischemic in the others. Each patient had suffered a severe brain injury and became comatose thereafter. Increased intracranial pressure was evident from clinical findings, necropsy changes, or both. While in coma, each patient had at lease one episode of hypotension. The data suggest that perisulcal infarcts are a manifestation of diminished vascular perfusion during a period of increased intracranial pressure.

Chronic alcoholism: report of an autopsy case and comparison with pseudoulegyric type of hepatocerebral degeneration

An autopsy case diagnosed as chronic alcoholism was reported. He clinically showed progressive neurological illness. His CNS lesions were composed of disseminated necrotic foci in the cerebral cortices with many Alzheimer type II astrocytes, pachymeningitis hemorrhagica interna, and lesions similar to pellagra and Wernicke encephalopathy. Some clinical and pathological analogous features between chronic alcoholism and pseudoulegyric type of hepatocerebral degeneration were discussed.