Selective sparing of Betz cells in primary motor area in hypoxic-ischemic encephalopathy

Two cases of postoperative hypoxic-ischemic encephalopathy are described in which Betz cells of the primary motor area were selectively spared. In one patient the hypoxic-ischemic encephalopathy led to a vegetative state and in the other patient to a spastic quadriparesis and cortical blindness. In contrast to the relative sparing of Betz cells, Purkinje cells of the cerebellar cortex were totally destroyed. These two cases suggest that Betz cells are relatively resistant to hypoxic-ischemic insult under certain conditions.