Abstract
There has been a tremendous improvement on the neonatal cares, nevertheless cerebral complications are still left behind the progress. The author have had some opportunity to study autopsy cases in the medical facilities which has been leaders in the field of neonatal medical care in Japan.
In this paper the author studied morphologically 50 fetal and neonatal autopsy cases obtained in the Juntendo Medical College in recent 5 years, also reviewed 750 autopsy cases in the Tokyo Mothers and Children Health Facility and Tsukiji Lying Hospital in the period of 1955 to 1977.
Methods ; 1) Stereoscopic observation of the vascular system by a modified Pickworth's method. 2) Determination of the water volume of the cerebral white matters. 3) Macrostaining of the cranium to demonstrate the state of cranial bone developments by a alizalin red-alcianblue method.
Conclusion ; 1. The primary site of the hemorrhages are in the boundary zone of the brain artery based on the cerebral vascular flow of premature infants. The premature infants revealed lager volumes of water in the tissue. The water volumes are larger in the intraventricular hemorrhage group than in the non-hemorrhage group in every body weights classes. The water volume is also larger in the intravenous infusion therapy group. The auther conclude that the rupture of specifically localiped veins cause a blocking effect for venous flow by way of mechanical pressure at the level of fornix near the intervetricular foramen. In the subependymal area an anoxic damage due to hypoxia can cause intraventricular hemorrhage in association with venous blocking effect by the edematous fornix. The clinical facts that the diseas appears frequently in premature infants and increase in the intravenous infusion therapy group, those are elucidated thus morphologilly.
2. Periventricular leucomalacia, which is particulary noted recently, can be understood as a disease in the boundary zone of the superficial artery or the ventricular artery of brain.3. On the ponto-subicular neuronal necrosis, which is emphasized as a manifestation of the anoxia by Friede is demonstrated (provede) as a pathological picture caused by the compression of brain tissues by the vessels in cerebellar tentorial edge, it will be influenced rather by the birth traumatic and mechanical factors. 4. Occipital osteodiastasis has been rather frequently overlooked, but in the cranium of premature infants before 30 weeks of gestation, a zone of cartilage remains between the basis and squma of occipital bone, and thus diastasis is easily to explain.
