Cerebral edema with diabetes mellitus
The first work on this issue was publishedin the XIX century and concerned single cases of brain studies of patients with diabetes mellitus. died from a cerebral stroke. Over the past 50 years, a large number of studies have appeared, a review of which was given earlier, devoted to the study of the brain in patients who died from ketoacidotic coma. Significant degenerative changes in ganglion cells of the cerebral cortex, extrapyramidal system, hypothalamus, hippocampus, medulla oblongata, as well as in the endothelium of capillaries of cerebrovascular plexuses were revealed. Proliferative changes in glia were noted in the marginal areas of the cortex and in the subependymal region.
In experimental diabetes, significant changes were observed in the following nuclei of the hypothalamus: supraoptic, paraventricular, ventromedial, and arcuate.
According to a number of authors, a characteristic featurechanges in cerebral vessels in diabetes is a combination of cerebral atherosclerosis (macroangiopathy) with diabetic microangiopathy. These changes, in particular, are found in patients who have a duration of juvenile diabetes from 16 to 34 years. The latter also have foci of softening and expressed diffuse degenerative changes in the brain tissue, often with symmetrical pseudocalcinates in the pale sphere and the jagged nucleus.
Extensive literature is devoted to violations,which appeared in the brain in sick people, as well as in experimental animals under the influence of numerous hypoglycemia. Diffuse degenerative and atrophic changes of nerve cells, demyelination, expansion of intracerebral vessels, hyperemia of the cerebral membrane, brain edema, cysts, isolated necrosis of various parts of the brain, numerous thrombi and perivascular hemorrhages in the hippocampus, oblong brain, striatum and other areas brain, subdural hemorrhages, etc.
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