Hirano bodies in myelinated fibers of hepatic encephalopathy

Inclusions, essentially identical to Hirano bodies, were observed in the substantia nigra, dentate nuclei, and frontal lobes in three autopsy cases of hepatic encephalopathy. Similar inclusions were not observed in these areas in nine controls. The inclusions were mainly seen in the inner loops of the myelinated fibers, between the myelin lamellae, and among degenerated myelin sheaths. The same inclusions were rarely observed in postsynaptic terminals.