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Brain damage after heat stroke
- Source :
- Journal of neuropathology and experimental neurology. 64(11)
- Publication Year :
- 2005
-
Abstract
- Cerebellar syndromes and radiologic cerebellar atrophy after hyperpyrexia have occasionally been reported, mostly in neuroleptic malignant syndromes, but neuropathologic studies are extremely rare. We studied 3 patients (a 74-year-old woman, a 63-year-old man, and an 80-year-old man) who had heat stroke during heat waves in France. One patient had generalized seizures and died 28 hours after admission. The other patients survived one month and 2 months after admission; both had palatal myoclonus, and in one case, magnetic resonance imaging showed high signal intensity in the cerebral peduncles. The main neuropathology in the 3 cases was severe diffuse loss of Purkinje cells associated with heat shock protein 70 expression by Bergmann glia. In situ end labeling was negative in surviving Purkinje cells, suggesting that the mechanism of neuronal death was not apoptosis. Degeneration of Purkinje cells axons resulted in myelin pallor of the white matter of the folia and of the hilum of the dentate nuclei. DNA internucleosomal breakages were identified by in situ end labeling in the dentate nuclei and centromedian nuclei of the thalamus and were associated with degeneration of the cerebellar efferent pathways: superior cerebellar peduncles, decussation of the superior cerebellar peduncles (Wernekinck commissure), and dentatothalamic tract. These findings suggest that the mechanisms of neuronal death in the dentate nuclei and centromedian nuclei of the thalamus was different from that in Purkinje cells and more likely resulted from deafferentation. Ammon's horn and other areas susceptible to hypoxia were spared. These observations confirm the selective vulnerability of Purkinje cells to heat-induced injury and involvement of the cerebellar efferent pathways in palatal myoclonus.
- Subjects :
- Male
Pathology
medicine.medical_specialty
Cerebellum
Dentatothalamic tract
Heat Stroke
Thalamus
Pathology and Forensic Medicine
White matter
Cellular and Molecular Neuroscience
medicine
Humans
HSP70 Heat-Shock Proteins
Aged
Aged, 80 and over
Brain Diseases
Palatal myoclonus
business.industry
Cerebral peduncle
General Medicine
Anatomy
Middle Aged
medicine.disease
Immunohistochemistry
Magnetic Resonance Imaging
medicine.anatomical_structure
nervous system
Neurology
Cerebellar peduncle
Cerebellar atrophy
Female
Neurology (clinical)
business
Subjects
Details
- ISSN :
- 00223069
- Volume :
- 64
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of neuropathology and experimental neurology
- Accession number :
- edsair.doi.dedup.....152117b202f54689dee9bf31e035fb9b