Journal für Hirnforschung: Band 19, Heft 6 1978 [Reprint 2021 ed.] 9783112519783, 9783112519776

Citation preview

ISSN 0021-8359

Ml

• USW-. B a n d 1§

Jj

j^pgj

für Hirnforschung Begründet von Cécile und Oskar Vogt Herausgeber: J. Anthony, Paris • A Hopf, Düsseldorf W.Kirsche, Berlin • J.Szentägothai, Budapest Schriftleitung: W. Kirsche, Berlin Wiss. Sekretär: J.Wenzel, Berlin

Akademie-Verlag • Berlin EVP 25,-M- 32105

Begründet von Cécile und Oskar Vogt Unter Mitwirkung des Cécile und Oskar Vogt Instituts für Hirnforschung in Düsseldorf und der Arbeitsgemeinschaft für vergleichende Neuroanatomie der Fédération mondiale de Neurologie (World Federation of Neurology) Mitherausgeber: H. ADAM, Salzburg — Wien O. S . ADRIANOW, Moskau J . ARIÉNS KAPPERS,

Amsterdam

E . CROSBY, Ann Arbor A. DEWULF, Corbeck-Lo J . ESCOLAR, Zaragoza R . HASSLER, F r a n k f u r t a. M. E . HERZOG, S a n t i a g o J . JANSEN, Oslo J . KONORSKI, W a r s c h a u ST. KÖRNYEY, P é c s

M. MARIN-PADILLA, Hanover-New Hampshire

Le JOURNAL F Ü R HIRNFORSCHUNG publiera des études sur la morphologie normale (anatomie, histologie, cytologie, microscopie électronique, histochimie), sur le développement du système nerveux ainsi que des études anatomiques expérimentales. On acceptera aussi des travaux du caractère de la coopération entre des domaines différents à condition qu'ils contiennent des résultats morphologiques obtenus par les méthodes de la neuromorphologie et de la neurophysiologie ou de la neuropharmacologie et de la neurochimie. Les travaux doivent contenir des acquisitions nouvelles sur l'action réciproque entre la structure et la fonction. Des études neuropathologiques seront seulement acceptées quand elles contribuent à la conaissance des structures normales, des changements structurels ou de leur signification fonctionelle. Des études sur la localisation cérebrale de phénomènes expérimentaux ou cliniques d'excitation ou de déficit (doctrine des localisations) seront également publiées par le JOURNAL F Ü R HIRNFORSCHUNG. Une partie spéciale sera réservée à la neurobiologie comparée.

J . MARÉALA, Koäice H . A. MATZKE, L a w r e n c e

D. MISKOLCZY, Tirgu Mures G. PILLERI, W a l d a u - B e r n T . OGAWA, T o k y o

B. REXED, Upsala

H . STEPHAN, F r a n k f u r t a. M. W . J . C. VERHAART, Leiden M. VOGT, Cambridge F . WALBERG, Oslo K . G. WINGSTRAND, K o p e n h a g e n E . WINKELMANN, Leipzig W . WÜNSCHER, Berlin A. D . ZURABASHVILI, Tbilissi

Im J O U R N A L F Ü R HIRNFORSCHUNG werden Arbeiten aus dem Gesamtgebiet der normalen Morphologie (Anatomie, Histologie, Cytologie, Elektronenmikroskopie, Histochemie) und der Entwicklungsgeschichte des Nervensystems unter Einschluß experimentell-anatomischer Arbeiten veröffentlicht. Es werden auch Arbeiten multidisziplinären Charakters aufgenommen, sofern sie morphologische Ergebnisse beinhalten, die mit neuromorphologischen und neurophysiologischen oder neuropharmakologischen bzw. neurochemischen Methoden gewonnen wurden und einen Erkenntnisgewinn hinsichtlich der Wechselwirkung zwischen Struktur und Funktion beinhalten. Neuropathologische Arbeiten werden nur angenommen, wenn sie Beiträge zur normalen Struktur, den Strukturwandlungen oder deren funktionellen Bedeutungen enthalten. Zum Publikationsgebiet des JOURNAL F Ü R HIRNFORSCHUNG gehören auch Arbeiten, die sich mit der Zuordnung experimenteller Reiz- und Ausfallerscheinungen bzw. klinischen Symptomen zu bestimmten Strukturen des Gehirns („Lokalisationslehre") befassen. Als spezielles Publikationsgebiet ist die vergleichende Neurobiologie vorgesehen.

The J O U R N A L F Ü R HIRNFORSCHUNG will publish studies on normal morphology (anatomy, histology, cytology, electron microscopy, histochemistry), on the development of the nervous system, as well experimental anatomical studies. Papers of multidisciplinary character will also be included so far as they contain morphological results which were obtained using neuromorphological and neurophysiological or neuropharmacological and neurochemical methods and provide further information on the interaction between structure and function. Neuropathological studies will only be published of they contribute to the knowledge of normal structures structurals changes or their functional significance. Papers dealing with the cerebral localization of experimental excitation and deficit phenomena or clinical symptoms (localization theory) will also be published by the JOURNAL F Ü R HIRNFORSCHUNG. A special part of the publication is reserved for comparative neurobiology.

Bezugsmöglichkeiten des „Journal für Hirnforschung". Bestellungen sind zu richten — in der D D R an eine Buchhandlung oder an den AkademieVerlag, D D R -108 Berlin, Leipziger Straße 3 - 4 — im sozialistischen Ausland an eine Buchhandlung für fremdsprachige Literatur oder an den zuständigen Postzeitungsvertrieb — in der B R D und Westberlin an eine Buchhandlung oder an die Auslieferungsstelle KUNST UND WISSEN, Erich Bieber, 7 Stuttgart 1, Wilhelmstraße 4 — 6 — in Österreich an den Globus-Buchvertrieb, 1201 Wien, Höchstädtplatz 3 — im übrigen Ausland an den Internationalen Buch- und Zeitschriftenhandel; den Buchexport, Volkseigener Außenhandelsbetrieb der Deutschen Demokratischen Republik, D D R - 701 Leipzig, Postfach 160, oder an den Akademie-Verlag, DDR-108 Berlin, Leipziger Straße 3 - 4 — in den übrigen westeuropäischen Ländern an eine Buchhandlung oder an die Auslieferungsstelle KUNST UND WISSEN, Erich Bieber GmbH, CH-8008 Zürich/Schweiz, Dufourstraße 51

Journal für Hirnforschung Herausgeber: Im Auftrag des Akademie-Verlages von einem internationalen Wissenschaftlerkollektiv herausgegeben. Verlag: Akademie-Verlag, D D R - 1 0 8 Berlin, Leipziger Straße 3 - 4 ; Fernruf: 2236 221 oder 2236 229; Telex-Nr.: 114420; Bank: Staatsbank der DDR, Berlin, Kto.-Nr.: 6836-26-20712. Schriftleitung: Prof. Dr. sc. med. W. Kirsche, Berlin. Veröffentlicht unter der Lizenznummer 1326 des Presseamtes beim Vorsitzenden des Ministerrates der Deutschen Demokratischen Republik. Gesamtherstellung: V E B Druckhaus „Maxim Gorki", D D R - 74 Altenburg. Erscheinungsweise: Das Journal für Hirnforschung erscheint jährlich in einem Band mit 6 Heften. Bezugspreis eines Bandes 180,— M zuzüglich Versandspesen (Preis für die D D R 1 5 0 , - M); Preis je Heft 30,— M (Preis für die D D R 2 5 , - M). Bestellnummer dieses Heftes 1018/19/6. © 1978 by Akademie-Verlag Berlin. Printed in the German Democratic Republic. AN (EDV) 60315

ISSN 0021- 8359 J . Hirnforsch. 19 (1978) 485—495

Journal

Internationales Journal für Neurobiologie H e f t 6 • 1978 • B a n d 19

"pQ p

Hirnforschung

F r o m the D e p a r t m e n t of Pathology, I n s t i t u t e of Obstetrics and Gynecology, Medical Academy, Gdansk, Poland

Morphogenesis of cerebral matrix ectopies in human fetus and newborn

By Maria

HRABOWSKA

W i t h 12figures and 4 tables (Received November 24, 1977)

S u m m a r y : T h e subject of investigations was genesis of periventricular, cerebral m a t r i x ectopies in human fetuses and newborns. T h e morphologic and histochemical analysis concerned the embryonal elements of the ventricular wall: namely neuroepithelium with m e m b r a n a limitans e x t e r n a and suporficial layer of the germinal matrix. I t has been distinguished four stages in the development of ectopic changes: 1) atrophy of neuroepithelium, 2) superficial necrobiosis with disruption'of m e m b r a n a limitans externa, 3) egsophytic neuroglial ectopies with organization or sequestration within the ventricular light, 4) neuroepithelial inclusions in the periventricular zone. T h e disclosed, destructive changes in superficial layers of t h e germinal m a t r i x as well as their glial organization suggested t h a t reparative processes t h a t could be an evidence of the passed perinatal hypoxia occur in t h e ventricular light.

TOWBIN'S papers (1969 a, b) as well as MYERS'S (1969a, b, 1972, 1975) BRANN and MYERS (1975) Many authors in their considerations concerning the ADAMSONS and MYERS (1973) experimental studies pathogenesis of psychomotoric or intelectual deficits seem among others, to evidence the purposefulness indicate the perinatal hypoxia as one of the etiologic of continuation of the pathomorphological studies on factors' (CROME and STERN, 1972; MYERS, 1972; perinatal damage in the central nervous system SCHOLZ a n d HAGER, 1 9 5 6 ; TOWBIN, 1 9 6 9 a , b , 1 9 7 0 , (TWAROWSKA and RUCKA, 1974). These authors have 1971; WHO,-1972). The epidemiologic data have dis- found both, in the autopsied and in the experimental closed the existence of correlation between delayed material, the morphologic features of the passed mental maturity, and hypoxic episodes observed hypoxic episodes in CNS, in individuals characterized during the perinatal period. It affects especially the by psychomotoric disorders. premature children or infants born with the sympDuring the perinatal period, the most susceptible toms of hypoxic syndrome (AUROUX, 1974a, b ; . region of CNS to hypoxic consequences is the lateral wall and the anterior angle of the lateral ventricle GOERTCHEN a n d .WIEDERSBERG, 1 9 7 6 ; TSUNG-YI LIN and STANDLEY, 1962). In spite of the progress in lined by deposits of the germinal matrix. In human genetics, the determination of the proper cause of infants the germinal matrix remains during the first mental retardation is difficult in a part of the cases year of extrafetal life and then becomes progressively (CROME a n d STERN, 1 9 7 2 ; HALLERVORDEN and exhausted' (KAHLE, 1951, 1 9 5 6 ; ' OPALSKI, 1934a; M E Y E R , 1956; TSUNG-YI LIN and STANDLEY, 1962). OSTERTAG, 1 9 5 6 a , b , 1 9 6 2 ; SPATZ, 1 9 2 5 / 2 6 ) . T h e

Introduction

Hirnforschung, Bd. 19, Heft 6

35

486

Hrabowska, M.

susceptibility

of t h e

germinal

matrix

of CNS

to

h y p o x i a , originates from high needs of proliferating tissue for m e t a b o l i c s u b s t r a t e s as well as f r o m t h e anatomical

relations

(in

the

lateral

wall

of

the

a n t e r i o r angle, in t h e periventricular zone, pass t h e great

venous

tributaries

of v e n a

(BANKER a n d LARROCHE,

1962;

cerebri

interna)

LARROCHE,

1.964;

DAMSBKA et al. 1 9 7 1 a , b ; DEREUCK, 1 9 7 1 , DEREUCK et al.

1972;

GRONTOFT, 1 9 5 3 ; GRUENEWALD, 1 9 5 1 ;

LEECH a n d BILWORTH, 1 9 7 4 ) . I t is well known t h a t t h e results of m a t r i x h y p o x i a are manifested b y oedemas, congestions, h a e m o r r h a gic infarctions a n d are c o m p l i c a t e d in a p a r t of t h e cases

by

intraventricular

haemorrhage wall

haemorrhage

penetration

(DAMBSKA et

WIEDERSBERG,

al.

1976;

through

1971a, b;

the

following ventricular

GOERTCHEN

HALLERVORDEN a n d

and

MEYER,

1 9 5 6 ; GRUNNET e t al. 1 9 7 4 ; HARRISON e t al.

1968;

TERPLEM, 1 9 6 7 ) . I n t h e present s t u d y during t h e morphologic investigations of C N S of autopsied fetuses a n d newborns, our special interest c o n c e r n e d t h e deposits of periventricular

germinal

matrix

and

neuroepithelium

lining t h e v e n t r i c u l a r surface. T h e a i m of t h e s t u d y has

been

the

morphologic

e l e m e n t s : neuroepithelium,

analysis

of

embryonal

m e m b r a n a limitans e x -

t e r n a a n d superficial layers of germinal m a t r i x , in perinatal h y p o x i a . T h e description of t h e m o r p h o logic lesions h a s been chiefly based on these cases, in which t h e r e w a s found neither a n i n t r a v e n t r i c u l a r haemorrhage

nor

diffuse

periventricular

haemorr-

hagic infarctions or h a e m o r r h a g e s within t h e chorioid s t r o m a , because considering t h e dimensions of t h e lesions it could be difficult t o differentiate previous d a m a g e from t h e s e c o n d a r y changes.

Material and methods The morphologic evaluation of the lesions in CNS has been analysed in three fetal periods, according to WHO recommendations (1972). The first was the early fetal age counted to 140th day of fetal life or up to 350 g of body weight, the second was the middle fetal age counted from the 141st to 195th day of the fetal life or up to 1,000 g of body weight. The late fetal age was that counted from the 196th day or above 1,000 g of body weight. The material consists of 1,279 cases of fetuses, newborns and infants autopsied during the period from Jan. I. 1973 till Dec. 31. 1976 in the Institute of Obstetrics and Gynecology of the Medical Academy in Gdansk. The data concerning sex, age, body weight of autopsied stillborns and newborns and the time of survival of infants are presented in table 1 and 2. Table 3 contains the data concerning the morphologic findings which caused the death of liveborn infants. The youngest fetuses came from the 8 — 10th week of development and they were obtained during the operations of ectopic pregnancy or from the amputated uterus in the cases of invasive cancer of the uterine cervix, discovered in the mothers. In this

group of cases (17 fetuses) nervous tissue was fixed in period, which not exceeded 5 minutes after the arrest of placental circulation. This procedure allowed us to form a comparable control group and facilitated the exclusion of autolytic nature of investigated changes. Four fetuses originating from early fetal age were born with signs of life. The most numerous group of infants survived from 4 to 24 hours. The oldest child survived 7 weeks. The presented below morphologic lesions, were sometimes found only in one hemisphere while in the other there appeared perivascular haemorrhages in the germinal matrix. The cases of periventricular malacia, and the cases of purulent leptomeningitis as well as the cases with traumatic lesions of dura mater were excluded from the analysis. The observed lesions within the germinal matrix and neuroepithelium were compared, among others, with the appearence of cortical or subcortical neurocytes of the brain trunc. Sections from the following internal organs were taken for histologic studies: lungs, heart, adrenals, thymus, spleen and liver, kidneys, and also numerous sections from the brain and spinal cord. The sections were fixed in 1 0 % buffered formalin or Carnoy's fluid. The fixations of the nervous tissue lasted 10 — 14 days and after this period the brain and spinal cord were sectioned by taking frontal sections through hemisphere and trunc and sometimes the saggital sections through frontal and parietal cortex were used. The purposeful sections containing the periventricular germinal matrix included: the walls of the anterior and inferior angle, white substance with differentiating striatum, thalamus, and also insular, hyppocampic, parietal and frontal cortex. Where brain originated from an elder child sections of the above mentioned structures were located in several blocks. Many times, especially in the brains originating from middle fetal age both hemispheres were cut simultaneously, so the sections contained not only the walls of the lateral ventricles but also the walls of the third ventricle and aquaeduct. The sections were embedded in paraffin or in paraffin and celoidin. The slides were stained with hematoxylin and eosin (H. E.), also with Weigert's ferric hematoxylin. In a part of the cases the serial slides were prepared. The nervous cells and their processes were stained with cresyl violet according to Nissl in Spielmeyer's modification. The reticular fibres were impregnated with silver accroding to Gomori. Collagen fibres were demonstrated with picrofuchsin by van Gieson's method. Elastic fibres were demonstrated according to Verhoeff's method, and also by pentachrome stain in Movat's modification. Fibrin and glial fibres were demonstrated by means of hematoxylinphosphate wolframate (PTAH) according to Mallory. Neutral mucopolysaccharides were demonstrated with PAS reaction according to McManus with control digestion of the tissue by cristalline amylase. Glycogen was demonstrated by Schiff's reagent after blocking the aldehyd groups by dimedon according to Bulmer. Calcium deposits were demonstrated by means of von Koss's method. Desoxyribonucleic acid (DNA) was demonstrated with Feulgen's method and ribonucleic acid (RNA) by means of pyronine Y and methyl green according to Unna-Pappenheim. Enzymatic control was performed by the use of cristalline ribonuclease (E.C.2.7.7.16-RNAse, B D H ) in concentration 0.1 to 0.5 mg/ml in temp. 37°C. Lipids were demonstrated by means of long Ziehl-Neelsen's method as described by Pearse for acid lipofuscin and also by means of Nil's blue and Sudan black B carried out on frozen and paraffin sections. Neutral

Morphogenesis of cerebral matrix ectopies lipids were demonstrated by oil red. The ionized iron was demonstrated with Turnbull's reaction and modified reaction on Berlin's blue. Myelin sheaths were stained by means of Heidenhain's method, in part of the cases astrocytic glia was demonstrated by Cajal's method, and fibrous glia by Kanzler-Arendt's method. The slides that contained hyalin deposits were stained by means of Kongo red and the results were read in a polarizing microscope. Alkaline phosphatase (E.C.3.1.1.1.-AP), acidic phosphatase (E.C.3.1.3.2.AcP) and leucine aminopeptidase (E.C.3.4.11-LAP) were demonstrated according to Burstone's methods using frozen sections.

487

T a b l e 3. The causes of death of liveborn infants Body weight (g)

350-1,000

Sex

?