Abstract
Unusual neuropathological changes were observed in two cases following extensive burns. These consisted of perivascular areas of demyelination distributed symmetrically in the brain and affecting the white matter predominantly. One case in addition had widespread petecchial and ring haemorrhages characteristic of brain purpura. Both patients sustained second and third degree burns in greater than 50% of the body surface area, developed metabolic acidosis, sepsis, disturbance in consciousness and multiple episodes of cardiorespiratory arrest prior to death. A toxic metabolic state related to a burn toxin released from the damaged tissue or from bacterial action to the tissue in addition to low platelet level is proposed as the major pathogenetic factor in the development of the neurological symptoms and the patients' demise.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Allgöwer M., Burri C., Cueni L., Engley F., Fleisch H., Gruber U. F., Harder F., Russell R. G. Study of burn toxins. Ann N Y Acad Sci. 1968 Aug 14;150(3):807–815. doi: 10.1111/j.1749-6632.1968.tb14732.x. [DOI] [PubMed] [Google Scholar]
- Allgöwer M., Cueni L. B., Städtler K., Schoenenberger G. A. Burn toxin in mouse skin. J Trauma. 1973 Feb;13(2):95–111. doi: 10.1097/00005373-197302000-00002. [DOI] [PubMed] [Google Scholar]
- Colmant H. J., Naeve W. Tödliche Purpura cerebri nach kurzzeitiger Einatmung von Nitrosegasen (Nitrosegas-Vergiftung) Z Rechtsmed. 1975 Nov 11;76(2):149–157. doi: 10.1007/BF00200561. [DOI] [PubMed] [Google Scholar]
- Graham D. I., Behan P. O., More I. A. Brain damage complicating septic shock: acute haemorrhagic leucoencephalitis as a complication of the generalised Shwartzman reaction. J Neurol Neurosurg Psychiatry. 1979 Jan;42(1):19–28. doi: 10.1136/jnnp.42.1.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
- LADWIG H. A. The central nervous system in thrombotic thrombocytopenic purpura. Neurology. 1953 Apr;3(4):267–276. doi: 10.1212/wnl.3.4.267. [DOI] [PubMed] [Google Scholar]
- LANDER H. A case of acute haemorrhagic leucoencephalitis (Hurst) complicating varicella. J Pathol Bacteriol. 1955 Jul;70(1):157–165. doi: 10.1002/path.1700700114. [DOI] [PubMed] [Google Scholar]
- LEVINE S., STYPULKOWSKI W. Experimental cyanide encephalopathy. AMA Arch Pathol. 1959 Mar;67(3):306–323. [PubMed] [Google Scholar]
- MADOW L., ALPERS B. J. Brain changes in patients with extensive body burns. AMA Arch Neurol Psychiatry. 1954 Oct;72(4):440–451. doi: 10.1001/archneurpsyc.1954.02330040042003. [DOI] [PubMed] [Google Scholar]
- Mukada T., Sasano N., Sato K. Autopsy findings in a case of acute paraquat poisoning with extensive cerebral purpura. Tohoku J Exp Med. 1978 Jul;125(3):253–263. doi: 10.1620/tjem.125.253. [DOI] [PubMed] [Google Scholar]
- Rosenthal S. R., Thadhani K. C., Crouse G., Spurrier W. Human "burn toxin" and in-vitro-produced "antitoxin". Ann N Y Acad Sci. 1968 Aug 14;150(3):792–806. doi: 10.1111/j.1749-6632.1968.tb14731.x. [DOI] [PubMed] [Google Scholar]
- SCHWEDENBERG T. H. Leukoencephalopathy following carbon monoxide asphyxia. J Neuropathol Exp Neurol. 1959 Oct;18:597–608. doi: 10.1097/00005072-195910000-00012. [DOI] [PubMed] [Google Scholar]
- Sepulchre C., Moati F., Miskulin M., Huisman O., Moczar E., Robert A. M., Monteil R., Guilbaud J. Biochemical and pharmacological properties of a neurotoxic protein isolated from the blood serum of heavily burned patients. J Pathol. 1979 Mar;127(3):137–145. doi: 10.1002/path.1711270306. [DOI] [PubMed] [Google Scholar]
- Walker J., Shenkin H. Studies on the Toxemia Syndrome After Burns II: Central Nervous System Changes as a Cause of Death. Ann Surg. 1945 Mar;121(3):301–313. doi: 10.1097/00000658-194503000-00005. [DOI] [PMC free article] [PubMed] [Google Scholar]