Neurological Degeneration in General Paresis

In considerable loss of the tangential and also of the radial fibers. This is but a natural consequence of the degeneration of the cell bodies above described. In the nerve fibers of the white matter changes are also found. Patches and streaks of gray degeneration were found in the immediately subcortical substance and Tuczek observed a like degeneration in the fibers between the cortex and medulla, which sometimes appeared as a gray streak or stripe. Similar changes may be found in the corpus callosum, fornix, septum lucidum and crura cerebri. In the optic thalami, corpora striata^, pons, medulla and cerebellum, vascular changes and cell degeneration, similar to those occurring in the cortex, are more or less markedly present. Degeneration of the cells constituting the bulbar nuclei is a most common lesion. Its relationship with many of the characteristic physical symptoms, viz: weakness of the facial muscles, tongue, etc., is apparent. The important microscopic changes in the brain may be summarized as follows: An increase in the number of nuclei in the walls of the capillaries with a thickening and granular appearance of their walls. A more or less intense round-cell infiltration of the adventitia of the arterioles. Blocking up of the peri- vascular, or lymph, spaces with leucocytes, hema- toidin and cellular debris, with here and there dilata- tion of these spaces. An affection of other vessels iNeurolog. Centralblatt, April i» 1899. 258 PATHOLOGY AND PATHOLOGICAL ANATOMY. with that form of degeneration known as hyaline fibroid degeneration, or arterio-capillary fibrosis. A marked hypertrophy and increase in number of those elements of the neuroglia, known as Deiters' cells, the lymph connective tissue of Bevan Lewis, this being especially marked along the course of the blood-vessels. Degeneration of the nerve cell, the most common being the pigmentary or yellow globular form and consequent disappearance of nerve fibers in different parts of the brain. Spinal Cord. — The relationship between microscopic changes found in the cord and the prominence of spinal symptoms is identical with the statement made on p. 250 in describing macroscopic appearances. The walls of the blood-vessels, especially those of the posterior columns, are thickened. The appearance, however, usually differs from that of the cerebral vessels, in that the lumen is diminished and the mus- cular coat hypertrophied. The lymph channels are not blocked up or dilated, and there is no nuclear proliferation. Bevan Lewis looks upon this change as