ARSPHENAMINE ENCEPHALOPATHY

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Abstract
The clinical and pathologic observations in cases of hemorrhagic encephalopathy due to arsphenamine usually present a fairly characteristic picture. A few hours or days after an intravenous injection of an arsphenamine preparation acute cerebral symptoms develop, especially headache, nausea, vomiting and fever, and the patient rapidly becomes comatose. Meningitic signs are usually absent except in cases in which subarachnoid bleeding has occurred. The cerebrospinal fluid is usually normal except for having increased pressure. Autopsy generally reveals marked dilatation and engorgement of the meningeal and cerebral vessels, varying degrees of vascular necrosis and perivascular hemorrhages, typically of the "ring" type. Meningeal hemorrhages may be present. A mild perivascular inflammatory infiltration is sometimes noted. Perivascular softening and demyelinization as the outstanding lesion has been described.1 The case herein reported is unusual in that it presented a frank meningitic as well as encephalopathic syndrome and because of the unusually intense leukocytic inflammatory

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