Neuropathology of Brainstem in Severe Cerebral Palsy Mainly Due to Perinatal Asphyxia

Abstract

The neuropathology of brainstem was studied on 27 patients, with ages rainging from 2 to 26 years 23 patients with cerebral palsy due to perinatal asphyxia (15), kernicterus (4), and encephalitis or encephalopathy (4), and 4 mentally retarded patients without cerebral palsy. Their clinical findings were confirmed by histological lesions in the brainstem, cerebrum, thalamus, basal nuclei and cerebellum.
The brainstem lesions were common among patients with severe cerebral palsy. The most common brainstem lesions of the perinatal asphyxia were found in the inferior olivary nucleus, vestibular nucleus, vagus nucleus, and pontine nucleus, with secondary degeneration of the pyramidal tract. There were less common damages in the reticular formation of medulla, superior colliculus, inferior colliculus, substantia nigra, red nucleus, oculomotor nucleus, trigeminal nucleus and hypoglossal nucleus.
The reactive astrocytosis was found even in the area of mild nerve cell damages.
These neuropathologic findings support Ozawa's and Torok's results that vestibular dysfunction was relatively common among cerebral palsy patients.