Apallic Syndrome in Diseases of the Cerebral White Matter

Abstract

Apallic syndromes after acute cerebral lesions, e.g., severe cerebral trauma and acute cerebral anoxia, are well-known conditions that have been much discussed in recent years. In acute cerebral anoxia there is primarily some damage to the cerebral cortex (Ingvar and Brun, 1972). Due to this general lesion, an apallic syndrome—in the literal sense, a “demantling” of the brain—develops. In the traumatic apallic syndrome, the compression of the midbrain with its consequences, besides edema of the white matter, contributes materially to the development of the apallic syndrome. Such clinical pictures, occurring dramatically after acute-lesions of the cerebral cortex or parts of the brain stem, have diverted attention from the fact that a disconnection of the primarily intact cerebral cortex from the primarily intact brain stem structures may also lead to similar conditions.