[When does the brain atrophy in Creutzfeldt-Jakob disease? (author's transl)]

Chronological changes of computerized tomography (CT) findings and clinical signs and symptoms were studied in 3 patients of Creutzfeldt-Jakob disease. CT revealed no brain atrophy in the stage when the patients showed frequent myoclonus and fell rapidly into the state of akinetic mutism. One autopsied case of this stage showed no macroscopical brain atrophy at all. Microscopical examination revealed extensive spongiform change in cerebral cortices (except for hippocampus), thalamus, basal ganglia, midbrain and a part of cerebellar cortex, but neuronal loss and gliosis were not severe. In other 2 cases conspicuous brain atrophy was noted in CT several months after this rapidly worsening period. Therefore when discussing pathological findings of Creutzfeldt-Jakob disease, we must consider when the patient died in the clinical course of this disorder.