Diseases of the nervous system : a text-book of neurology and psychiatry . mbar region. Thevessels are congested and their sheaths infiltrated, the progressionof the inflammatory reaction apparently following the vessels fromthe periphery within the cord. The cerebrospinal fluid is increased inquantity, almost opalescent early in the disease, with markedlyincreased lymphocytes, in some of which Lafora and Hough have ACUTE POLIOENCEPHALOMYELITIS 307 found pictures resembling the Leishman-Donovan bodies. The fluidlater becomes clearer, but still shows a pathological increase inleukocytes. Within
Diseases of the nervous system : a text-book of neurology and psychiatry . mbar region. Thevessels are congested and their sheaths infiltrated, the progressionof the inflammatory reaction apparently following the vessels fromthe periphery within the cord. The cerebrospinal fluid is increased inquantity, almost opalescent early in the disease, with markedlyincreased lymphocytes, in some of which Lafora and Hough have ACUTE POLIOENCEPHALOMYELITIS 307 found pictures resembling the Leishman-Donovan bodies. The fluidlater becomes clearer, but still shows a pathological increase inleukocytes. Within the cord the inflammatory process follows the pial processesinto the depths of the anterior fissure and along the sheaths of thecentral vessels. The posterior root fibers and the spinal ganglia arealso infiltrated. The vascular lesions are particularly noticeable, and the interstitialand ganglionic changes depend largely upon them. The vesselsthroughout are dilated and engorged, the capillaries often beingenormously distended. This marked hyperemia is found throughout,. Fig. 152.—Acute poliomyelitis, showing A,associated meningitis; B, edge of cord. Fig. 153.—Acute poliomyelitis,showing the vascular congestion andthe surrounding infiltration. Theanterior spinal artery. and vascular hemorrhagic lytic changes are frequent but small. Asin rabies, and to some extent in syphilis, there is a marked perivascularor intra-adventitial infiltration, apparently of lymphocytes, not plasmacells. Interstitial changes in the gray and white matter, chiefly of aninfiltration of cells, and proliferation of glia cells, occur. By reason ofthe rich blood supply the gray matter of the anterior horns bears thebrunt of the inflammatory edema and hyperemia, with destruction ofmany of its motor cells. This is a secondary process. Harbitz andScheel believe that small abscesses take place, but this is an exceptionif it does occur. The ganglion cells undergo varying degrees of degeneration, some-what p
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