Six children were 1 1/2 to 3 years of age. Five gave a history of the ingestion of paint from walls or painted furniture for 4-6 months. Five died within 8 days of the onset of acute symptoms. The 6th child survived for 39 days. The clinical course was characterized by vomiting, headache, drowsiness, stupor or coma, papilledema, and alterations in pupillary size and reaction. Pathologically, considerable swelling of the brain was evident in the 5 acute cases, and 1 of these revealed numerous petechial hemorrhages in the cortex of 1 occipital lobe. Microscopically, 4 of these showed partial loss of myelin and an astrocytic reaction in the white matter. Three of these showed perivascular edema and petechial hemorrhages. The chronic case revealed extensive tissue destruction with cavity formation, associated with marked astrocytic and microglial reaction. The veins showed thickening and cellular disorganization of their walls and very recent thrombosis of dural sinuses. The pathologic appearance suggests that vascular damage is a major factor in the pathogenesis of the cerebral disorder.