@misc{Mossakowski_Mirosław_Jan_(1929–2001)_Encephalopathia_1964,
 author={Mossakowski, Mirosław Jan (1929–2001) and Paluszkiewicz-Szymchel, Jadwiga},
 volume={2},
 number={1},
 copyright={Creative Commons Attribution BY 4.0 license},
 address={Warszawa},
 journal={Neuropatologia Polska},
 howpublished={online},
 year={1964},
 publisher={Państwowy Zakład Wydawnictw Lekarskich},
 language={eng},
 abstract={The authors report the case of a 67-year old female who suffered for a few years from cholecystitis, hepatic cirrhosis and bleeding from esophageal varices. One and half year ago an anastomosis of the portal vein with the inferior vena cava was performed. On admission to the hospital marked pyramidal and increasing extrapyramidal and psychoorganic syndromes were observed as well as periodic loss of consciousness and intermittent coma lasting several days. Proteins and electrolite levels and acid-alkali balance were seriously disordered.Postmortem examination revealed changes characteristic of liver encephalopathy with status spongiosus of the cerebral cortex and subcortical white matter, most marked in precentral gyrus, and presence of Anlzheimer’s glia type II in all gray structures of the brain. Best’s carmine-positive inclussions in naked nuclei were not observed. There were present in naked nuclei PAS-positive intranuclear granulations which more often sorrounded the nuclei. It seems that these granulations correspond to carbohydrate fraction of gray-greenish pigment noticed in routine staining.The authors point to the strinkingly low potassium level when the patient was unconscious. The ammonia level was normal. These data differ from those of other authors.Authors keep in mind nephrogenous mechanism i. e. chronic exacerbated pyelonephritis, but suggest complicated metabolic disorders in the course of liver encephalopathy. Ammonia perhaps is not the sole factor responsible for the disorders of consciousness. The clinical course as well as the data from the literature support this suggestion.},
 type={Text},
 title={Encephalopathia porto-systemica},
 URL={http://www.rcin.org.pl/Content/70591/PDF/publ_26.pdf},
 keywords={porto-systemic encephalopathy},
}