On Some Problems of Histological Diagnosis and Interpretation of Circulatory Disturbances in the Brain

Abstract

Originally the conception of disturbances of the cerebral circulation was closely associated with that of gross arterial and venous disease, and it was in these conditions that the typical pictures of hæmorrhages, hæmorrhagic and anæmic infarctions (softenings), scars and cysts as their sequelæ were first studied. These sequelæ are in all essentials the same in the brain as in other organs with similar vascular arrangements, such as the kidney and the spleen, with the exception of some peculiarities due to special structure or special staining reactions. Recent ischæmic necrosis of the grey matter appears in Nissl-stained specimens as areas of pallor, and examination under high magnification often reveals a special type of ganglion-cell change called ischæmic by Spielmeyer (16), which so far has maintained its reputation as being highly specific. A further peculiarity is provided by the activity of the glia in all processes of breakdown and repair. In vascular disease especially, a type of mobile glial-mesodermal activity is met with (Spielmeyer (16)), that is to say, the glia acts jointly with the mesenchymal tissue in the production of scavenger-cells and of fibres.