This is a follow-up study of a previous investigation of brain lesions in alcoholics during a five-year period from 1975 through 1979 (Torvik et al. 1982). The autopsy material from the 5-year period 1983-1987 was examined in order to see whether improved clinical treatment had resulted in a reduced frequency of alcohol-related brain lesions, paticularly of active Wernicke''s encephalopathy. The percentage of alcoholics (8.2 vs. 8.7%), the male/female ratio (4.2/1) and their mean age (60.4 vs. 62.2 years) were similar in the two recording periods, as was the frequency of alcoholic cerebellar atrophy (26.8 vs. 27.6%).In both periods the brain weight in male alcoholic cerebellar atrophy (26.8 vs. 27.6%). In both periods the brain weight in male alcoholics aged 40-70 years was significantly lower than in age-matched controls. This difference was not present after 70 years of age. The most important finding was considerable but not significant reduction of the frequency of active an inactive Wernicke''s encephalopathy in alcoholics. Review of the clinical records suppors the hypothesis that this reduction reflects better diagnostic and therapeutic procedures in the clinical departments. However, even during the last period most cases of active Wernicke''s encephalopathy were not recognized clinically and further improvement of the clinical management should therefore be possible.
