Neuropathological examinations were performed on 30 autopsy cases of severely handicapped children. Among them, 11 cases showed bilateral cerebral destructive lesions. The cerebral lesions were divided into three groups; six cases with dominantly grey matter lesions, three with dominantly white matter lesions and two with combined grey and white matter lesions. The cortical lesions were found in the fronto-parietooccipital lobes and cingulate gyri, while undersurface of the temporal lobes showed less destruction. The white matter lesions, consisting of marked gliosis and atrophy accompanied by ventricular dilatation, were remarkable in the area extending from the periventricular region to the centrum semiovale. These changes were more apparent in the occipital lobes.
Cerebellar lesions were found in nine cases, which also were classified into grey matter and white matter lesions. The extent and characteristics of these lesions resembled those of the cerebral lesions. The basal ganglia showed no remarkable destruction in the cases with severe cortical and subcortical damages. It was assumed that these nuclei had survived the disconnection from the cortex.
Thalamic lesions were observed in six cases, mainly restricted to the dorsal and/or lateral nuclei. No relationship was found between these thalamic lesions and the extent or intensity of cerebral destruction. It is suggested that each of the thalamic nuclei has a different characteristic vulnerability to such destructive conditions.