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An Autopsied Case of Schizophrenic Patient who died from Heat Stroke Kazuhiro Niizato 1 , Kuniaki Tsuchiya 2 , Kenichi Oshima 1 , Mizuho Togi 1 , Ryosuke Nakamura 1 , Hideki Ueno 1 , Kei Ito 3 , Haruhiko Akiyama 4 1Department of Psychiatry, Tokyo Metropolitan Matsuzawa Hospital 2Department of Laboratory Medicine and Pathology, Tokyo Metropolitan Matsuzawa Hospital 3Department of Rehabilitation, Higashi-Matsudo Hospital 4Department of Neuropathology, Tokyo Institute of Psychiatry Keyword: heat stroke , neuropathology , cerebellum , malignant syndrome , schizophrenia pp.418-424
Published Date 2006/5/1
DOI https://doi.org/10.11477/mf.1406100171
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A male residual schizophrenic out-patient of 65 years old had presented “heat stroke” and died in progressive course of 7 months. His mental condition had been stable and he had kept good drug compliance. In some summer day, he presented high fever and confusion, followed by convulsion. He showed over 40℃ high temperature (max 42℃) for about 6 hours. After 10 day's high serum CPK, he gradually presented severe muscle atrophy (proximal dominant), flaccid quadriplegia and brain atrophy (especially in cerebellum). He died from pneumonia.

 His brain weight was 1,350g. Neuropathological study showed severe loss of Purkinje cell with gliosis. Neurons in dentate nucleus ware entirely lost and a great amount of fatty macrophages were present around the dentate nucleus. Fatty macrophages were observed from cerebellum to red nucleus through superior cerebellar peduncle. These findings have been known as findings of heat stroke. Addition to these findings, this case presented a neuronal loss in the substantita nigra and in the anterior horn of spinal cord and the degeneration of bilateral pyramidal tract. These findings have not been thus far reported, so this case is thought to be the valuable case on considering the variation of neuropathology of “heat stroke”.


Copyright © 2006, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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