Lesions in SL are usually represented by focicollisional, and not coagulative necrosis. However, often they do not reach the stage of necrosis and can look like foci of "dissolution" and "loosening" (swelling, rarefaction) of white matter of the brain with a reduction in the number of axons and myelin compared to the surrounding brain substance.
Around the lesions of the SL appear changes,characteristic for TG - proliferating astrocytes of different species, basophilic globules, etc. With the development of the process, the stage of resorption begins with the accumulation in the centers of granular spheres. In the future, a cyst or gliosis scar is formed. As a result of CJI and TG, subcortical atrophy is formed, the anterior horns of the lateral ventricles of the brain and the interhemispheric furrow develop.
CJI can be combined with a submarine (in this casebrain damage is called "complex PL"), as well as with lesions of the cerebral cortex. In the lesions in the future, cysts or so-called "lace-like lesions" are formed. If these changes are represented by a number of foci localized in areas of adjacent blood circulation between the main cerebral arteries, then these changes become identical to those called "dehydration infarcts".
S. Takashima et al. For the first time, "subcortical leukomalacia" (SL), which was found in the "sudden death syndrome", was first identified as a special form of the white matter lesion of the brain. It should be noted that this term has already been used to denote the focus of rarefaction and edema of white matter in the brain of monkeys. Subcortical foci of necrosis were also detected by DB Clark and JW Anderson. The centers of SL represent foci of "dilution" of white matter of the brain with a reduction in the number of axons and myelin in comparison with the surrounding cerebral substance. In them axons are somewhat swollen, and around the foci there is no infiltration of micro-glial cell elements. All these features make it easy to distinguish the foci of SL from foci of PL, representing foci of predominantly coagulative necrosis. S. Takashima et al. note that they can not establish whether the lesions of the SL are the form of infarcts, the foci of selective axonal degeneration or areas of chronic edema. In addition, SL is found mainly in children after the first month of life, and PL in newborns.
Current page: Medicine, trauma in children during labor »Subcortical leukomalacia