Citomegalia e malformações do sistema nervoso central: relato de dois casos associados à agenesia do corpo caloso e encefalopatia cística

Becker, Paulo F. L.

doi:10.1590/S0004-282X1975000100001

Resumos

Dois casos de citomegalia do sistema nervoso central em lactentes, comprovados pelo encontro de inclusões virais típicas no tecido nervoso, associados à agenesia da comissura do corpo caloso e encefalopatía cística simétrica pós-infarto, são estudados sob o ponto de vista anátomo-clínico. O autor acredita que a agenesia tenha sido causada por transformação cística da lâmina reuniens e do sulco médio ocluido inoportunamente no período embrionário. Discute a possibilidade dessa malformação cerebral ter sido ocasionada pela virose, não excluindo, contudo, a hipótese de uma casual ocorrência da citomegalia num encéfalo previamente anômalo. Atribui a encefalopatia cística simétrica coexistente à uma redistribuição (desvio) do fluxo sangüíneo cerebral através do que denomina de sistema de irrigação prioritária. Este sistema, provavelmente, atua independentemente dos mecanismos de auto-regulação do fluxo sangüíneo cerebral e entra em ação em situações de emergência, com a finalidade de suprir os centros neurovegetativos homeostáticos de maior importância vital imediata, preservando-os em detrimento — se prolongado o desvio do fluxo sangüíneo — para os demais territórios do sistema nervoso central excluídos do circuito circulatório. Essas áreas, submetidas a uma isquemia relativa, manifestam infartos com características simétricas e sequelas subseqüentes, se o indivíduo sobreviver tempo suficiente para a reabsorpção dos detritos teciduais e substituição por áreas císticas, dada a extensão da necrose.

Two cases of cytomegaly of the central nervous system of infants, disclosing typical viral inclusions in the brain tissues, associated with agenesia of the corpus callosum and cystic symmetrical post-infarction encephalopathy are reported. It is suggested that the callosal defect was caused by cystic degeneration occuring within the lamina reuniens and the prematurely fused sulcus medianus, in early intrauterine life. The possibility of cytomegalic etiology of the malformation is discussed. However the occurrence of viral disease in a previous abnormal brain cannot be discarded. The cystic symmetrical encephalopathy is explained through a redistribution (shunting) of the cerebral blood flow, brought about by the existence of a peculiar mechanism which he calls — priority blood supplying system. This proposed system probably acts independently of the cerebral blood flow autoregulatory mechanisms in emergency states, shunting the blood to the vitaly more important homeostatic neurovegetative centers. This mechanism, in spite of its actual effectiveness, if prolonged, may be deleterious to the excluded territories and produce irreversible damages. The morphologic expression of these damages are the multiple symmetrical brain infarctions. Following occasional survival, the tissue debris of the destroyed structures in the involved areas, are slowly and progressively removed by reabsorption and replaced by unusual symmetrical cavitations.

Citomegalia e malformações do sistema nervoso central. Relato de dois casos associados à agenesia do corpo caloso e encefalopatia cística

Cytomegaly and central nervous system malformations. Report of two cases associated with agenesia of the corpus callosum and cystic encephalopathy

Paulo F. L. Becker

Professor Adjunto do Departamento de Patologia (Prof. Fritz Köberle), Faculdade de Medicina de Ribeirão Preto (USP), São Paulo, Brasil

RESUMO

Dois casos de citomegalia do sistema nervoso central em lactentes, comprovados pelo encontro de inclusões virais típicas no tecido nervoso, associados à agenesia da comissura do corpo caloso e encefalopatía cística simétrica pós-infarto, são estudados sob o ponto de vista anátomo-clínico. O autor acredita que a agenesia tenha sido causada por transformação cística da lâmina reuniens e do sulco médio ocluido inoportunamente no período embrionário. Discute a possibilidade dessa malformação cerebral ter sido ocasionada pela virose, não excluindo, contudo, a hipótese de uma casual ocorrência da citomegalia num encéfalo previamente anômalo. Atribui a encefalopatia cística simétrica coexistente à uma redistribuição (desvio) do fluxo sangüíneo cerebral através do que denomina de sistema de irrigação prioritária. Este sistema, provavelmente, atua independentemente dos mecanismos de auto-regulação do fluxo sangüíneo cerebral e entra em ação em situações de emergência, com a finalidade de suprir os centros neurovegetativos homeostáticos de maior importância vital imediata, preservando-os em detrimento se prolongado o desvio do fluxo sangüíneo para os demais territórios do sistema nervoso central excluídos do circuito circulatório. Essas áreas, submetidas a uma isquemia relativa, manifestam infartos com características simétricas e sequelas subseqüentes, se o indivíduo sobreviver tempo suficiente para a reabsorpção dos detritos teciduais e substituição por áreas císticas, dada a extensão da necrose.

SUMMARY

Two cases of cytomegaly of the central nervous system of infants, disclosing typical viral inclusions in the brain tissues, associated with agenesia of the corpus callosum and cystic symmetrical post-infarction encephalopathy are reported. It is suggested that the callosal defect was caused by cystic degeneration occuring within the lamina reuniens and the prematurely fused sulcus medianus, in early intrauterine life. The possibility of cytomegalic etiology of the malformation is discussed. However the occurrence of viral disease in a previous abnormal brain cannot be discarded. The cystic symmetrical encephalopathy is explained through a redistribution (shunting) of the cerebral blood flow, brought about by the existence of a peculiar mechanism which he calls priority blood supplying system. This proposed system probably acts independently of the cerebral blood flow autoregulatory mechanisms in emergency states, shunting the blood to the vitaly more important homeostatic neurovegetative centers. This mechanism, in spite of its actual effectiveness, if prolonged, may be deleterious to the excluded territories and produce irreversible damages. The morphologic expression of these damages are the multiple symmetrical brain infarctions. Following occasional survival, the tissue debris of the destroyed structures in the involved areas, are slowly and progressively removed by reabsorption and replaced by unusual symmetrical cavitations.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

Departamento de Patologia Faculdade de Medicina Caixa Postal 301 14100 Ribeirão Preto, SP Brasil.

1. BAIZ, T. C. & JAKOBY, R. K. Surgical treatment of an arteriovenous malformation associated with agenesis of the corpus callosum. J. Neurosurg. 21:306, 1964.
2. BAKER, R. C. & GRAVES, G. O. Partial agenesis of the corpus callosum. Arch. Neurol. Psychiat. (Chicago) 29:1054, 1933.
3. BANKER, R. Q. & LARROCHE, J. C. Periventricular leukomalacia of infancy. Arch. Neurol. (Chicago) 7:386, 1962.
4. BELL, W. E. & ALLEN, M. V. van Agenesis of the corpus callosum with associated facial anomalies. Neurology (Minneapolis) 9:694, 1959.
5. BELTER, L. F. & CAMILLO, M. Demonstration of cytomegalic inclusions in autolized fetal tissue. Am. J. Obst. Gynec. 78:1243, 1959.
6. BETZ, E. Cerebral blood flow: its measurement and regulation. Physiol. Rev. 52:295, 1972.
7. BRITO, T. de & MILANESI, M. L. Incidência da doença de inclusão citomegálica em necrópsias de rotina. Rev. Inst. Med. trop. São Paulo 6:119, 1964.
8. BÜCHNER, F. Allgemeine Pathologie (3. Auflage). Urban & Schwarzenberg, München/Berlin, 1959.
9. CARPENTER, M. B. & DRUCKEMILLER, W. H. Agenesis of the corpus callosum diagnosed during life. Arch. Neurol. Psychiat. (Chicago) 70:305, 1953.
10. CROME, L. & FRANCE, W. E. Microgyria and cytomegalic inclusion disease in infancy. J. Clin. Path. 12:427, 1959.
11. DAVIDOFF, L. M. & DYKE, C. G. Agenesis of the corpus callosum; its diagnosis by encephalography. Am. J. Roentg. 32:1, 1934.
12. DIEZEL, P. B. Mykrogyrie infolge cerebraler Speicheldrüsenvirusinfektion im Rahmen einer generalizierten Cytomegalie bei einem Säugling. Virchows Arch. 325:109, 1954.
13. DOBBING, J. Vulnerable periods of brain development. In Lipids, Malnutrition and the Developing Brain. (Ciba Foundation Symposium), Elsevier-Excerpta Medica, North-Holland Association of Scientific Publications, Amsterdam, 1972.
14. DOOLING, E. C; BARLOW, J. F.; MURPHY, J. V. & RICHARDSON, E. P. Cyst of the cavum septi pellucidi. Arch. Neurol. (Chicago) 27:79, 1972.
15. ECHTERNACHT, A. P. & CAMPBELL, J. A. Mid-line anomalies of the brain: their diagnosis by pneumoencephalography. Radiology 46:119, 1946.
16. EPPS, E. F. van Agenesis of the corpus callosum with concomitant malformations, including atresia of the foramens of Luschka and Magendie. Am. J. Roentg. 70:47, 1953.
17. FARBER, S. & CRAIG, J. M. Clinical pathological conference. Children's Medicine Center (Boston, Massachusetts). J. Pediat. 48:800, 1956.
18. FARIA, J. L. de Citomegalia em crianças: primeiros casos registrados no Brasil. Rev. paul. Med. (São Paulo) 50:153, 1957.
19. FAZEKAS, J. F.; ALEXANDER, F. A. D. & HIMWICH, H. E. Tolerance of the newborn to anoxia. Am. J. Physiol. 134:281, 1941.
20. FETTERMAN, G. H. A new laboratory aid in the clinical diagnosis of inclusion disease in infancy. Am. J. Clin. Path. 22:424, 1952.
21. HAYMACKER, W.; GIRD ANY, B. R.; STEPHENS, J.; LILLIE, R. D. & FETTERMAN, G. H. Cerebral involvement with advanced periventricular calcification in generalized cytomegalic inclusion disease in the newborn. J. Neuropath, exp. Neurol. 13:562, 1954.
22. HEWITT, W. The development of the human corpus callosum. J. Anat. (London) 96:355, 1962.
23. HIMWICH, H. E.; BERNSTEIN, A. O.; HERRLICH, H.; CHESLER, A. & FAZEKAS, J. F. Mechanisms for the maintenance of life in the newborn during anoxia. Am. J. Physiol. 135:387, 1942.
24. HOCHSTETTER, F. Beiträge zur Entwicklungsgeschichte des menschlichen Gehirns. F. Deuticke, Wien, 1929.
25. HOLMAN, C. B. & MACARTY, C. S. Cerebral angiography in agenesis of the corpus callosum. Radiology 72:317, 1959.
26. HOOFT, C. & DELBEKE, M. J. Contribution à l'étude de la maladie des inclusions cytomegaliques. Arch. franc. Pédiat. 17:914, 1960.
27. JOSEPHY, H. Congenital agyria and defect of the corpus callosum. J. Neuropath, exp. Neurol. 2:63, 1944.
28. KIDDER, L. A. Cerebral and visceral inclusion disease in infancy. Am. j. Clin. Path. 22:870, 1952.
29. KINNEY, D. T. Intranuclear inclusions in infancy. Am. J. Path. 18:799, 1942.
30. KIRSCHBAUM, W. R. Agenesis of the corpus callosum and associated malformations. J. Neuropath, exp. Neurol. 6:78, 1947.
31. KOCH, F. P. & DOYLE, P. J. Agenesis of the corpus callosum: report of eight cases in infancy. J. Pediat. 50:345, 1957.
32. KRAINER, L. Die Hirn und Rückenmarkslipome. Virchows Arch. 295:107, 1935.
33. LARROCHE, J. C. & BAUDEY, J. Cavum septi lucidi, cavum vergae, cavum veli interpositi: cavités de la ligne mediane. Biol. Neonat. 3:193, 1961.
34. LAURENCE, K. M. & WEEKS, R. Abnormalities of the central nervous system. In A. P. Norman (ed.) Congenital Abnormalities in Infancy (2nd. ed.), Blackwell Scientific Publi., Oxford, 1971.
35. LOESER, J. D. & ALVORD Jr., E. C. Clinico-pathological correlations in agenesis of the corpus callosum. Neurology (Minneapolis) 18:745, 1968.
36. LOESER, J. D. & ALVORD Jr., E. C. Agenesis of the corpus callosum. Brain 91:553, 1968.
37. MAFFEI, W. E. As Bases Anátomo-patológicas da Neuriatria e Psiquiatria (vol. I). Imprensa Metodista, São Paulo, 1951.
38. MARBURG, O. So-called agenesia of the corpus callosum (callosal defect): anterior cerebral dysraphism. Arch. Neurol. Psychiat. (Chicago) 61:297, 1949.
39. MENKES, J. H.; PHILIPPART, M. & CLARK, D. B. Hereditary partial agenesis of the corpus callosum. Arch. Neurol. (Chicago) 11:198, 1964.
40. MERCER, R. D.; LUSE, S. & GUYTON, D. H. Clinical diagnosis of generalized cytomegalic inclusion disease. Pediatrics 11:502, 1953.
41. MONIF, G. R. G. Viral Infections of the Human Fetus. Collier-MacMillan Ltd., London, 1969.
42. MORSIER, G. de Les syndromes vasculaires embryonnaires dans les malformations cérébrales. Schweiz. Arch. f. Neurol. u. Psychiat. 67: 440, 1951.
43. MORSIER, G. de & MOZER, J. J. Agénésie complète de la commissure calleuse et troubles du développement de l'hemisphère gauche avec hémiparésie droite et intégrité mentale (Le syndrome embryonnaire précoce de 1'artère cérébrale antérieure). Schweiz. Arch. f. Neurol. u. Psichiat. 35:64, 1935.
44. MOSBERG, W. H. & VORIS, H. C. An unusual congenital anomaly of the brain: agenesis of the corpus callosum, abscence of the septum pellucidum and fusion of the cerebral hemispheres. J. Neuropath, exp. Neurol. 13:369, 1954.
45. NAEYE, R. L. Cytomegalic inclusion disease: the fetal disorder. Am. J. Clin. Path. 47:738, 1967.
46. NAIMAN, J. & FRAZER, F. C. Agenesis of the corpus callosum. Arch. Neurol. Psychiat. (Chicago) 74:182, 1955.
47. NAVIN, J. J. & ANGEVINE, J. M. Congenital cytomegalic inclusion disease with porencephaly. Neurology (Minneapolis) 18:470, 1968.
48. PENFIELD, W. & HYNDMAN, O. R. Agenesis of the corpus callosum with discussion of ventriculograms in two living cases. Trans. Am. neurol. Ass. 60:182, 1934.
49. QUAN, A. & STRAUSS, L. Congenital cytomegalic inclusion disease: observations in a macerated fetus with congenital defect, including study of the placenta. Am. J. Obst. Gynec. 83:1240, 1962.
50. RAKIC, P. & YAKOVLEV, P. J. The development of the corpus callosum and cavum septi in man. J. Comp. Neurol. 132:45, 1968.
51. RENNERT, O. M. Viruses and congenital malformations. In G. R. G. Monif Viral Infection of the Human Fetus. Collier-MacMillan Ltd., London, 1969.
52. RIZZUTO, N. & MARTIN, L. Le problème de l'encephalopathie foetale kystique survenant au cours du deuxième tiers de la grossesse. Biol. Neonat. 11:115, 1967.
53. ROUNER, R. N. & WILLIAMS Jr., G. H. Diencephalic seizures accompanying agenesis of the corpus callosum. Trans. Am. neurol. Ass. 87:232, 1962.
54. SCHOLTZ, W. Selective neuronal necrosis and its topistic patterns in hipoxemia and oligemia. J. Neuropath. exp. Neurol. 12:249, 1953.
55. SCHWIDDE, J. T. Incidence of cavum septi pellucidi and cavum vergae in 1032 human brains. Arch. Psychiat. (Chicago) 67:625, 1952.
56. SEVER, J. & WHITE, L. R. Intrauterine viral infections. Ann. Rev. Med. 19:471, 1968.
57. SHAPIRO, W. R.; WILLIAMS, G. H. & PLUM, F. Spontaneous recurrent hypothermia accompanying agenesis of the corpus callosum. Brain 92:423, 1969.
58. SHAW, C. M. & ALVORD Jr., E. C. Cava septi pellucidi et vergae: their normal and pathological states. Brain 92:213, 1969.
59. SHEINMEL, A. & LAWRENCE, L. R. Agenesis of the corpus callosum: lipomas of the corpus callosum. Radiology 57:15, 1951.
60. SIEGMUND, H. Die Entstehung von Porencephalien und Sklerosen aus geburtstraumatischen Hirnschädigungen. Virchows Arch. 241:237, 1923.
61. SMITH, M. G. & VELLIOS, F. Inclusion disease or generalized salivary gland virus infection. Arch. path. (Chicago) 50:862, 1950.
62. STEWART, R. M. & ASHBY, W. R. Angioma arteriale racemosum in an acallosal brain: a clinical and pathological report. J. Neurol. Psychiat. (Chicago) 11:289, 1931.
63. THEOBALD, G. D. Cytomegalic inclusion disease. Am. j. Ophth. 47 (n.° 5, part II): 52, 1959.
64. TOWBIN, A. Congenital malformations. In J. Minckler (ed.) Pathology of the Central Nervous System (vol. II), MacGraw-Hill Book Co., New York, 1971.
65. VERRON, G. Klinische Beiträge zur generalisierten Cytomegalie. Ann. Paediat. (Basel) 185: 293, 1955.
66. VIRCHOW, R. Zur pathologischen Anatomie des Gehirns. 1. Congenitale Encephalitis und Myelitis. Virchows Arch. 38:129, 1867.
67. VIRCHOW, R. Ueber interstitielle Encephalitis. Virchows Arch. 44:472, 1868.
68. WOLF, A. & COWEN, D. The cerebral atrophies and encephalomalacias of infancy and childhood. In Res. Publ. Ass. Nerv Ment. Dis. vol. 34 (Neurology and Psychiatry in Childhood), 1954.
69. WOLF, A. & COWEN, D. Perinatal infections of the central nervous system. In J. Minckler (ed.) Pathology of the central nervous system (vol. III). McGraw-Hill Book Co., Springfield (Illinois), 1972.
70. WORTH, W. A. & HOWARD, H. L. New features of inclusion disease in infancy. Am. J. Path. 26:17, 1950.
71. WYATT, J. P.; SAXTON, J.; LEE, R. S. & PINKERTON, H. Generalized cytomegalic inclusion disease. J. Pediat. 36:271, 1950.
72. WYATT, J. P. & TRIBBY, W. W. Granulomatous encephalomyelitis in infancy. Arch. Path. (Chicago) 53:103, 1952.
73. ZINGESSER, L.; SCHECHTER, M.; GONATAS, N.; LEVY, A. & WISOFF, H. Agenesis of the corpus callosum associated with an inter-hemispheric arachnoid cyst. Brit. J. Radiol. 37:905, 1964.

Datas de Publicação

Publicação nesta coleção
09 Abr 2013
Data do Fascículo
Mar 1975

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. BAIZ, T. C. & JAKOBY, R. K. Surgical treatment of an arteriovenous malformation associated with agenesis of the corpus callosum. J. Neurosurg. 21:306, 1964.

[2] 2. BAKER, R. C. & GRAVES, G. O. Partial agenesis of the corpus callosum. Arch. Neurol. Psychiat. (Chicago) 29:1054, 1933.

[3] 3. BANKER, R. Q. & LARROCHE, J. C. Periventricular leukomalacia of infancy. Arch. Neurol. (Chicago) 7:386, 1962.

[4] 4. BELL, W. E. & ALLEN, M. V. van Agenesis of the corpus callosum with associated facial anomalies. Neurology (Minneapolis) 9:694, 1959.

[5] 5. BELTER, L. F. & CAMILLO, M. Demonstration of cytomegalic inclusions in autolized fetal tissue. Am. J. Obst. Gynec. 78:1243, 1959.

[6] 6. BETZ, E. Cerebral blood flow: its measurement and regulation. Physiol. Rev. 52:295, 1972.

[7] 7. BRITO, T. de & MILANESI, M. L. Incidência da doença de inclusão citomegálica em necrópsias de rotina. Rev. Inst. Med. trop. São Paulo 6:119, 1964.

[8] 8. BÜCHNER, F. Allgemeine Pathologie (3. Auflage). Urban & Schwarzenberg, München/Berlin, 1959.

[9] 9. CARPENTER, M. B. & DRUCKEMILLER, W. H. Agenesis of the corpus callosum diagnosed during life. Arch. Neurol. Psychiat. (Chicago) 70:305, 1953.

[10] 10. CROME, L. & FRANCE, W. E. Microgyria and cytomegalic inclusion disease in infancy. J. Clin. Path. 12:427, 1959.

[11] 11. DAVIDOFF, L. M. & DYKE, C. G. Agenesis of the corpus callosum; its diagnosis by encephalography. Am. J. Roentg. 32:1, 1934.

[12] 12. DIEZEL, P. B. Mykrogyrie infolge cerebraler Speicheldrüsenvirusinfektion im Rahmen einer generalizierten Cytomegalie bei einem Säugling. Virchows Arch. 325:109, 1954.

[13] 13. DOBBING, J. Vulnerable periods of brain development. In Lipids, Malnutrition and the Developing Brain. (Ciba Foundation Symposium), Elsevier-Excerpta Medica, North-Holland Association of Scientific Publications, Amsterdam, 1972.

[14] 14. DOOLING, E. C; BARLOW, J. F.; MURPHY, J. V. & RICHARDSON, E. P. Cyst of the cavum septi pellucidi. Arch. Neurol. (Chicago) 27:79, 1972.

[15] 15. ECHTERNACHT, A. P. & CAMPBELL, J. A. Mid-line anomalies of the brain: their diagnosis by pneumoencephalography. Radiology 46:119, 1946.

[16] 16. EPPS, E. F. van Agenesis of the corpus callosum with concomitant malformations, including atresia of the foramens of Luschka and Magendie. Am. J. Roentg. 70:47, 1953.

[17] 17. FARBER, S. & CRAIG, J. M. Clinical pathological conference. Children's Medicine Center (Boston, Massachusetts). J. Pediat. 48:800, 1956.

[18] 18. FARIA, J. L. de Citomegalia em crianças: primeiros casos registrados no Brasil. Rev. paul. Med. (São Paulo) 50:153, 1957.

[19] 19. FAZEKAS, J. F.; ALEXANDER, F. A. D. & HIMWICH, H. E. Tolerance of the newborn to anoxia. Am. J. Physiol. 134:281, 1941.

[20] 20. FETTERMAN, G. H. A new laboratory aid in the clinical diagnosis of inclusion disease in infancy. Am. J. Clin. Path. 22:424, 1952.

[21] 21. HAYMACKER, W.; GIRD ANY, B. R.; STEPHENS, J.; LILLIE, R. D. & FETTERMAN, G. H. Cerebral involvement with advanced periventricular calcification in generalized cytomegalic inclusion disease in the newborn. J. Neuropath, exp. Neurol. 13:562, 1954.

[22] 22. HEWITT, W. The development of the human corpus callosum. J. Anat. (London) 96:355, 1962.

[23] 23. HIMWICH, H. E.; BERNSTEIN, A. O.; HERRLICH, H.; CHESLER, A. & FAZEKAS, J. F. Mechanisms for the maintenance of life in the newborn during anoxia. Am. J. Physiol. 135:387, 1942.

[24] 24. HOCHSTETTER, F. Beiträge zur Entwicklungsgeschichte des menschlichen Gehirns. F. Deuticke, Wien, 1929.

[25] 25. HOLMAN, C. B. & MACARTY, C. S. Cerebral angiography in agenesis of the corpus callosum. Radiology 72:317, 1959.

[26] 26. HOOFT, C. & DELBEKE, M. J. Contribution à l'étude de la maladie des inclusions cytomegaliques. Arch. franc. Pédiat. 17:914, 1960.

[27] 27. JOSEPHY, H. Congenital agyria and defect of the corpus callosum. J. Neuropath, exp. Neurol. 2:63, 1944.

[28] 28. KIDDER, L. A. Cerebral and visceral inclusion disease in infancy. Am. j. Clin. Path. 22:870, 1952.

[29] 29. KINNEY, D. T. Intranuclear inclusions in infancy. Am. J. Path. 18:799, 1942.

[30] 30. KIRSCHBAUM, W. R. Agenesis of the corpus callosum and associated malformations. J. Neuropath, exp. Neurol. 6:78, 1947.

[31] 31. KOCH, F. P. & DOYLE, P. J. Agenesis of the corpus callosum: report of eight cases in infancy. J. Pediat. 50:345, 1957.

[32] 32. KRAINER, L. Die Hirn und Rückenmarkslipome. Virchows Arch. 295:107, 1935.

[33] 33. LARROCHE, J. C. & BAUDEY, J. Cavum septi lucidi, cavum vergae, cavum veli interpositi: cavités de la ligne mediane. Biol. Neonat. 3:193, 1961.

[34] 34. LAURENCE, K. M. & WEEKS, R. Abnormalities of the central nervous system. In A. P. Norman (ed.) Congenital Abnormalities in Infancy (2nd. ed.), Blackwell Scientific Publi., Oxford, 1971.

[35] 35. LOESER, J. D. & ALVORD Jr., E. C. Clinico-pathological correlations in agenesis of the corpus callosum. Neurology (Minneapolis) 18:745, 1968.

[36] 36. LOESER, J. D. & ALVORD Jr., E. C. Agenesis of the corpus callosum. Brain 91:553, 1968.

[37] 37. MAFFEI, W. E. As Bases Anátomo-patológicas da Neuriatria e Psiquiatria (vol. I). Imprensa Metodista, São Paulo, 1951.

[38] 38. MARBURG, O. So-called agenesia of the corpus callosum (callosal defect): anterior cerebral dysraphism. Arch. Neurol. Psychiat. (Chicago) 61:297, 1949.

[39] 39. MENKES, J. H.; PHILIPPART, M. & CLARK, D. B. Hereditary partial agenesis of the corpus callosum. Arch. Neurol. (Chicago) 11:198, 1964.

[40] 40. MERCER, R. D.; LUSE, S. & GUYTON, D. H. Clinical diagnosis of generalized cytomegalic inclusion disease. Pediatrics 11:502, 1953.

[41] 41. MONIF, G. R. G. Viral Infections of the Human Fetus. Collier-MacMillan Ltd., London, 1969.

[42] 42. MORSIER, G. de Les syndromes vasculaires embryonnaires dans les malformations cérébrales. Schweiz. Arch. f. Neurol. u. Psychiat. 67: 440, 1951.

[43] 43. MORSIER, G. de & MOZER, J. J. Agénésie complète de la commissure calleuse et troubles du développement de l'hemisphère gauche avec hémiparésie droite et intégrité mentale (Le syndrome embryonnaire précoce de 1'artère cérébrale antérieure). Schweiz. Arch. f. Neurol. u. Psichiat. 35:64, 1935.

[44] 44. MOSBERG, W. H. & VORIS, H. C. An unusual congenital anomaly of the brain: agenesis of the corpus callosum, abscence of the septum pellucidum and fusion of the cerebral hemispheres. J. Neuropath, exp. Neurol. 13:369, 1954.

[45] 45. NAEYE, R. L. Cytomegalic inclusion disease: the fetal disorder. Am. J. Clin. Path. 47:738, 1967.

[46] 46. NAIMAN, J. & FRAZER, F. C. Agenesis of the corpus callosum. Arch. Neurol. Psychiat. (Chicago) 74:182, 1955.

[47] 47. NAVIN, J. J. & ANGEVINE, J. M. Congenital cytomegalic inclusion disease with porencephaly. Neurology (Minneapolis) 18:470, 1968.

[48] 48. PENFIELD, W. & HYNDMAN, O. R. Agenesis of the corpus callosum with discussion of ventriculograms in two living cases. Trans. Am. neurol. Ass. 60:182, 1934.

[49] 49. QUAN, A. & STRAUSS, L. Congenital cytomegalic inclusion disease: observations in a macerated fetus with congenital defect, including study of the placenta. Am. J. Obst. Gynec. 83:1240, 1962.

[50] 50. RAKIC, P. & YAKOVLEV, P. J. The development of the corpus callosum and cavum septi in man. J. Comp. Neurol. 132:45, 1968.

[51] 51. RENNERT, O. M. Viruses and congenital malformations. In G. R. G. Monif Viral Infection of the Human Fetus. Collier-MacMillan Ltd., London, 1969.

[52] 52. RIZZUTO, N. & MARTIN, L. Le problème de l'encephalopathie foetale kystique survenant au cours du deuxième tiers de la grossesse. Biol. Neonat. 11:115, 1967.

[53] 53. ROUNER, R. N. & WILLIAMS Jr., G. H. Diencephalic seizures accompanying agenesis of the corpus callosum. Trans. Am. neurol. Ass. 87:232, 1962.

[54] 54. SCHOLTZ, W. Selective neuronal necrosis and its topistic patterns in hipoxemia and oligemia. J. Neuropath. exp. Neurol. 12:249, 1953.

[55] 55. SCHWIDDE, J. T. Incidence of cavum septi pellucidi and cavum vergae in 1032 human brains. Arch. Psychiat. (Chicago) 67:625, 1952.

[56] 56. SEVER, J. & WHITE, L. R. Intrauterine viral infections. Ann. Rev. Med. 19:471, 1968.

[57] 57. SHAPIRO, W. R.; WILLIAMS, G. H. & PLUM, F. Spontaneous recurrent hypothermia accompanying agenesis of the corpus callosum. Brain 92:423, 1969.

[58] 58. SHAW, C. M. & ALVORD Jr., E. C. Cava septi pellucidi et vergae: their normal and pathological states. Brain 92:213, 1969.

[59] 59. SHEINMEL, A. & LAWRENCE, L. R. Agenesis of the corpus callosum: lipomas of the corpus callosum. Radiology 57:15, 1951.

[60] 60. SIEGMUND, H. Die Entstehung von Porencephalien und Sklerosen aus geburtstraumatischen Hirnschädigungen. Virchows Arch. 241:237, 1923.

[61] 61. SMITH, M. G. & VELLIOS, F. Inclusion disease or generalized salivary gland virus infection. Arch. path. (Chicago) 50:862, 1950.

[62] 62. STEWART, R. M. & ASHBY, W. R. Angioma arteriale racemosum in an acallosal brain: a clinical and pathological report. J. Neurol. Psychiat. (Chicago) 11:289, 1931.

[63] 63. THEOBALD, G. D. Cytomegalic inclusion disease. Am. j. Ophth. 47 (n.° 5, part II): 52, 1959.

[64] 64. TOWBIN, A. Congenital malformations. In J. Minckler (ed.) Pathology of the Central Nervous System (vol. II), MacGraw-Hill Book Co., New York, 1971.

[65] 65. VERRON, G. Klinische Beiträge zur generalisierten Cytomegalie. Ann. Paediat. (Basel) 185: 293, 1955.

[66] 66. VIRCHOW, R. Zur pathologischen Anatomie des Gehirns. 1. Congenitale Encephalitis und Myelitis. Virchows Arch. 38:129, 1867.

[67] 67. VIRCHOW, R. Ueber interstitielle Encephalitis. Virchows Arch. 44:472, 1868.

[68] 68. WOLF, A. & COWEN, D. The cerebral atrophies and encephalomalacias of infancy and childhood. In Res. Publ. Ass. Nerv Ment. Dis. vol. 34 (Neurology and Psychiatry in Childhood), 1954.

[69] 69. WOLF, A. & COWEN, D. Perinatal infections of the central nervous system. In J. Minckler (ed.) Pathology of the central nervous system (vol. III). McGraw-Hill Book Co., Springfield (Illinois), 1972.

[70] 70. WORTH, W. A. & HOWARD, H. L. New features of inclusion disease in infancy. Am. J. Path. 26:17, 1950.

[71] 71. WYATT, J. P.; SAXTON, J.; LEE, R. S. & PINKERTON, H. Generalized cytomegalic inclusion disease. J. Pediat. 36:271, 1950.

[72] 72. WYATT, J. P. & TRIBBY, W. W. Granulomatous encephalomyelitis in infancy. Arch. Path. (Chicago) 53:103, 1952.

[73] 73. ZINGESSER, L.; SCHECHTER, M.; GONATAS, N.; LEVY, A. & WISOFF, H. Agenesis of the corpus callosum associated with an inter-hemispheric arachnoid cyst. Brit. J. Radiol. 37:905, 1964.

Brasil

Brasil

Citomegalia e malformações do sistema nervoso central: relato de dois casos associados à agenesia do corpo caloso e encefalopatia cística

Cytomegaly and central nervous system malformations: report of two cases associated with agenesia of the corpus callosum and cystic encephalopathy

Resumos

Datas de Publicação