3 - Griffiths & Laurence (1974) and Grunnet et al.
(1974)
Griffiths and Laurence (1974) investigated the effects
of perinatal hypoxia and perinatal hypoxia plus
hypoglycemia [1]. They did not find significant
neuropathological differences between 17 hypoxic
infants who died shortly after birth and 17 infants who
were both hypoxic and hypoglycemic; if anything the
hypoglycemic infants sustained slightly less damage
within the brain. Hypoxia was inferred for infants who
had low Apgar scores at birth (0-3) and/or recurrent
apneic attacks.
The cerebral cortex, thalamus and cerebellum were
damaged in most cases, but it was noted that damage
was also invariably found at some level of the
brainstem. Brainstem sites most frequently involved
were the nucleus of the inferior colliculus, part of the
superior colliculus (large cells in the deep layers), and
the substantia nigra in the midbrain. In the pons and
medulla motor nuclei of the trigeminal nerves, nuclei
ambiguii, inferior olives, cuneate nuclei, and other
cranial nerve nuclei were affected.
Grunnet et al. (1974) examined the brains of 105
consecutive infants with respiratory distress who died
in the perinatal period [2]. They identified two groups
of infants: In the first group, of 82 babies, all were
born earlier than 38 weeks gestation; all in the second
group of 23 were considered full-term (born after
38-40 weeks gestation).
Four major types of pathology were found in the brain:
(1) hemorrhages or cysts of the germinal plate were
found in 62 of the pre-term infants but not in any of
the full-term infants. (2) Reactive astrocytosis of
unmyelinated cerebral and cerebellar white matter
was found in 43 of the pre-term and 14 of the full-term
infants. Astrocytosis was distinguished from normal
premyelination gliosis. (3) Neuronal loss and
astrocytosis of cerebral cortex and /or hippocampus
was found in only 9 of the pre-term infants, but 10
(almost half) of those born full-term. (4) Spongy
changes or gliosis in cranial nerve nuclei or inferior
colliculi were found in 2 pre-term and 2 full-term
infants. Like Norman (1972) these findings were
compared with those reported by Ranck and Windle
(1959) in mokeys asphyxiated at birth [3, 4].
- Griffiths AD, Laurence KM
(1974) The effect of hypoxia
and hypoglycemia on the
brain of the newborn human
infant.
- Grunnet ML et al. (1974)
Brain changes in newborns
from an intensive care unit.
- Norman MG (1972)
Antenatal neuronal loss and
gliosis of the reticular
formation, thalamus, and
hypothalamus. A report of
three cases.
- Ranck JB, Windle WF
(1959). Brain damage in the
monkey, Macaca mulatta, by
asphyxia neonatorum.
- Griffiths AD, Laurence KM (1974) The effect of hypoxia and hypoglycemia on the brain of
the newborn human infant. Developmental Medicine and Child Neurology 16:308-319.
- Grunnet ML, Curless RG, Bray PF, Jung AL (1974) Brain changes in newborns from an
intensive care unit. Developmental Medicine and Child Neurology 16:320-328.
- Norman MG (1972) Antenatal neuronal loss and gliosis of the reticular formation,
thalamus, and hypothalamus. A report of three cases. Neurology (Minneapolis) 22:910-
916.
- Ranck JB, Windle WF (1959). Brain damage in the monkey, Macaca mulatta, by asphyxia
neonatorum. Experimental Neurology 1:130-154.