LESIONS OF THE WHITE MATTER OF THE CENTRAL NERVOUS SYSTEM

Publisher Website
Google Scholar
Abstract
A detailed histopathologic study was made of cases of encephalopathy following chemotherapy, brain injury, cerebral fat embolism, inflammatory diseases of the nervous system and CO exposure. In all of these cases the major pathologic change was in the white matter, and the author found a characteristic vascular alteration spoken of as "vaso-paralysis" in many of these cases. This change was confined chiefly to the veins and capillaries of the white matter. The author believes that the retarded circulation interfered with adequate supply of nutrition to the vessel wall itself. If the alteration was severe enough and of prolonged duration, there occurred degeneration of the vessel wall which led to increased permeability, which would account for edema and hemorrhage which were frequently observed to be confined to the white matter. Different regions of the nervous system are characterized by differences in the pattern of the blood supply. The regional peculiarity of vascularization of the white matter appeared to be responsible for its selective vulnerability. The reaction of the nervous system depends upon the localization, regardless of etiology, and the changes in distribution of lesions are influenced primarily by the local structure and particularly by its vascular supply. The most severe forms of tissue destruction were seen in areas with poor blood supply, and the regions with the most abundant vascular supply were relatively spared.

This publication has 3 references indexed in Scilit: