Anterograde transneuronal degeneration in the limbic system: clinical-anatomic correlation

A 64-year-old man with diffuse atherosclerosis developed an organic mental syndrome, followed by hypothalamic symptoms. Autopsy showed an old large cystic infarct involving the left temporal lobe including the hippocampus, and atrophy of the ipsilateral fornix, mammillary body, hypothalamus, mammillothalamic tract, and the anterior thalamic nucleus. The clinical deterioration and pathologic findings may be explained by anterograde transneuronal degeneration within the limbic system following the infarction.