Abstract
Clinical cases of Japanese encephalitis were observed, especially as to the relationship between the clinical features and the autopsy findings in four cases.
1) The clinical features coincided well with the autopsy findings
.2) Arteriosclerosis in aged patients seemed to aggravate the circulatory disturbances caused by the encephalitis in its acute and subacute stages, resulting in irreversible brain damages. In such cases, secondary intracerebral hemorrhage or wide-spread encephalomalacia is often fatal.
3) As for the proper changes concerning blood vessels in the eacute encephalitic stage, congestion and petechiae were histologically observed; in severe cases, subarachnoideal hemorrhage and hematuria were not rare in their acme stage. These findings suggest that as much attention should be paid to the blood vessel disorders as to the secondary infections.
4) On the basis of the above findings, the authors could successfully treat one aged patient with hemostatics, especially large dosages of carbazochrome, combined with ACTH, adrenal corticoids, γ-globulin, a brain pressure depressant, and a brain metabolism stimulant.
5) As a supplement, the authors here report on a case of acute encephalitis, the symptoms of which are quite similar to those of Japanese encephalitis, but, as revealed by serological examinations, is caused by the ECHO-4 virus.
