Brainstem Damage in the Prematurely Born Infants;Clinical and Neuropathological Study

Abstract

Clinical and neuropathological studies were done on the brain stem of 88 prematurely born infants. There were 12 cases with neuronal loss and astrogliosis in the inferior olivary nuclei, 2 cases with neuronal lossin the tegmentum of the brain stem, and 11 cases with recent or old necrosis in the pontine nuclei.
The neuronal loss and astrogliosis in the inferior olivary nuclei was closely related with the cerebellar hemisphere lesions such as cerebellar hemorrhage or loss of Purkinje cells and astrogliosis in the cerebellar white matter. This olivary lesion may be a secondary change to the damage of the cerebellar hemisphere.
The clinical history and the distribution of the lesions suggested that the neuronal loss in the tegmentum of the brain stem was due to hypotensive brainstem necrosis, and that the necrosis in the pontine nuclei was a hypoxic change such as pontosubicular necrosis in most cases or a secondary change to cerebellar hemispheric lesions in some cases.