Fatty change in the brain in perinatal and unexpected death

The presence of fat-laden cells in the cerebrospinal fluid is usually associated with a fatty change found particularly in the area of the tapetum in the postnatal infant. In a series of 307 child deaths the presence of fatty change in this area of the brain was age-related, decreased with age, and was rarely present over the age of 4 years. It was particularly common in stillborns and in children dying with respiratory distress, but was rare in children dying from acute surgical conditions or from acute infections. It was found in one-half of a series of 41 infants found unexpectedly dead and in whom no adequate cause of death was found. The most likely cause of this fatty change is thought to be chronic hypoxia.