�ber die Zusammenh�nge zwischen anatomischem Befund und klinischem Bild bei Rindenprellungsherden nach stumpfem Sch�deltrauma

Autopsies on 195 male alcoholics aged 30-64 years who died outside hospitals and nursing homes in Oslo from 1984 to 1988, were carried out at the Institute of Forensic Medicine, Rikshospitalet. In 127 cases brain tissue was examined neuropathologically, 86 (67.7%) showed abnormalities and 28 contained lesions of more than one type. Lesions associated with alcoholism were found in 61 cases (48%), 18 (14.2%) showed Wernicke's encephalopathy, 47 (37%) cerebellar atrophy, 2 central pontine myelinolysis and 1 hepatic encephalopathy. Subdural haematoma and/or cortical contusions were found in 30 cases (23.6%) and cerebrovascular lesions in 19 (15%). Of the 195 cases, 22 had a history of recurrent convulsive attacks of which 19 were examined neuropathologically and 13 had focal damage that could have caused epileptic fits. Although cerebral damage was more frequent among vagrants and other persons dependent on social support, 50% of the alcoholics living in their own homes were also affected. Alcohol-related disease was considered the cause of death in 15 of 127 cases examined neuropathologically and 9 of these died from acute Wernicke's encephalopathy all of whom were sober at death. Although the post mortem analyses included neuropathological examination of the brain, the cause of death remained unknown in 27 (21%) of the 127 cases.

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“…The frequency of old cortical contusions in this material was more than six times that (2.5%) found in a large German population [22].…”

Section: Discussionmentioning

confidence: 96%

Cerebral lesions and causes of death in male alcoholics

Skullerud

Andersen

Lundevall³

1991

Int J Leg Med

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“…O trauma pode ser inclusive de pequena intensidade, mas devido à relativa baixa pressão do espaço subdural, o sangue acumula com pouca compressão, fenômeno esse facilitado pela maior capacidade de acomodação do cérebro atrófico 26 , explicando assim sua presença em séries de necropsia de pacientes procedentes de um hospital geral. Contusão antiga foi observada em 2,5% de 2 mil necropsias de um hospital geral 27 , o que confirma o conceito de que as contusões são lesões geralmente compatí-veis com boa evolução clínica, quando não associadas com outras lesões crânio-encefálicas traumáti-cas 28 .…”

Section: Discussionunclassified

Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997

Pittella

Duarte

2002

Arq. Neuro-Psiquiatr.

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RESUMO -Objetivo: Descrever a prevalência e os tipos das doenças cerebrovasculares (DCVs) em indivíduos idosos necropsiados. Método: Foram consultados os laudos neuropatológicos de 242 pacientes com idade igual ou superior a 61 anos, procedentes em sua maioria do Hospital das Clínicas da Universidade Federal de Minas Gerais, em Belo Horizonte, Minas Gerais, e necropsiados consecutivamente no período 1976 a 1997. Resultados: Os principais grupos de doenças do sistema nervoso central (SNC) foram representados por DCVs (71,9%), infecções (12,4%), neoplasias (7,1%), traumatismos crânio-encefálicos (3,7%), doenças nutricionais (2,5%) e doenças degenerativas (1,7%). As DCVs mais frequentes foram: aterosclerose (61,2%), doença cerebrovascular hipertensiva (25,6%) e infarto cerebral (14,9%). Observou-se aumento da frequência e da gravidade da aterosclerose e da frequência da doença cerebrovascular hipertensiva com o avançar da idade. Houve associação significativa entre doença cerebrovascular hipertensiva e aterosclerose. As DCVs foram clinicamente sintomáticas e as responsáveis diretas pelo óbito em 42,7% e 17,3% dos pacientes, respectivamente. Conclusão: As DCVs constituíram o principal grupo de doenças do SNC no idoso. A aterosclerose e a doença cerebrovascular hipertensiva foram as principais doenças deste grupo, notando-se aumento de sua frequência com o avançar da idade e associação significativa entre ambas. The prevalent diseases of the central nervous system (CNS) found in decreasing order were: CVDs (71.9%), infections (12.4%), neoplasms (7.1%), head trauma (3.7%), nutritional diseases (2.5%) and degenerative diseases (1.7%). The most common CVDs were cerebral atherosclerosis (61.2%), hypertensive cerebrovascular disease (25.6%) and cerebral infarct (14.9%). There was an increase in prevalence and severity of atherosclerosis and an increase in prevalence of hypertensive cerebrovascular disease with advancing age. A significant association between hypertensive cerebrovascular disease and atherosclerosis was found. The CVDs patients had clinical stroke and this was the direct cause of death in 42,7% and 17,3% of the cases, respectively. Conclusion: The CVDs were the most prevalent group of diseases of the CNS in elderly patients. Atherosclerosis and hypertensive cerebrovascular disease were the most common CVDs, and its prevalence increased with advancing age. Hypertensive cerebrovascular disease was significantly associated with atherosclerosis.

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“…The cortex at the edge of healed contusions is often gliosed and may contain calcified neurons. Healed contusions were an incidental finding in 25 % of 2,000 consecutive necropsies reported by Welte (1948).…”

Section: Contusions and Lacerationsmentioning

confidence: 99%

Lesions in the cerebral hemispheres after blunt head injury.

Strich¹

1970

Journal of Clinical Pathology

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�ber die Zusammenh�nge zwischen anatomischem Befund und klinischem Bild bei Rindenprellungsherden nach stumpfem Sch�deltrauma

Cited by 46 publications

References 52 publications

Cerebral lesions and causes of death in male alcoholics

Cerebral lesions and causes of death in male alcoholics

Prevalência e padrão de distribuição das doenças cerebrovasculares em 242 idosos, procedentes de um hospital geral, necropsiados em Belo Horizonte, Minas Gerais, no período de 1976 a 1997

Lesions in the cerebral hemispheres after blunt head injury.

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