Neuropathologic Correlates of Supratentorial Lesions in Traumatic and Nontraumatic Apallic Syndrome
Since it is impossible to produce experimentally a clinical condition which would correspond to the apallic syndrome in man, the only reliable source of information remains the human model, i.e., the clinicopathologic correlation of human cases. However, there has not yet been a general agreement on the various aspects and criteria of definition for the syndrome. Because of this, the clinical data received by the neuropathologist may vary from place to place giving the correlation a rather subjective flavor. The other problem on the clinical side of the correlation is the technical value and grade of precision of clinical data. The apallic patients with long survival are sometimes too routinely followed and recorded in the latter stages of the disease. In such cases it is sometimes difficult to reconstruct precisely the course of the disease and the chronology of events, which may be of great importance for the later anatomic analysis. On the other hand, the acute cases—especially traumatic and ischemic ones—are often, during the whole first phase of the disease, treated in general hospitals or emergency units of general surgery, where some of the special neurologic examinations may not be carried out, with the result that important information may later be missing. Taking into account the fact that the apallic syndrome is essentially a transient clinical phenomenon, a syndrome of unpredictable onset, of variable course, and of varying duration, it is understandable that we have to be able to operate with very accurate records on the course of the clinical disease in which the apallic syndrome occurred.
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