[Autopsy case of progressive subcortical gliosis]

A case of a 44-year-old male with progressive subcortical gliosis was presented. The clinical manifestations included mental activity, difficulty in attention, euphoria and inability to work. The impairement of memory was not evident and his personality was fairly well preserved. Neurological examination showed no abnormality. The course was progressive without remission and the patient died with pneumonia approximately fifteen months after the onset of the disease. Laboratory tests revealed unremarkable except for slight degree of glucosuria and elevated F.B.S. Electroencephalography and carotid angiography were within normal. Neuropathological finding revealed that brain weighed 1200 g. and moderate degree of atrophy on frontal to parietotemporal lobes was evident. Occipital lobe was not involved. Microscopic examination revealed such changes as fibrillary gliosis in the cerebral white matter and grey matter in the spinal cord. The lesion in the cerebral white matter was predominent in the frontal lobe. Striatum and brain stem also showed mild degree of fibrillary gliosis. No senility related change such as senile plaque, granulovacuolar degeneration and Alzheimer's neurofibrillary tangle was found. The clinicopathologic findings in this case supported a diagnosis of progressive subcortical gliosis which was first described by Neumann in 1949.