Features of atherosclerosis of the cerebral arteries and pathomorphology of cerebral infarctions in patients with type 2 diabetes mellitus

Abstract

Comparison of the results of 20 autopsy cases of ischemic strokesdeveloped during atherosclerosis with 20 autopsy cases of ischemicstrokes associated with atherosclerosis in combination withtype 2 diabetes mellitus (T2DM) provided data indicating a highsignificance of T2DM in the development of severe changesin the cerebral arteries, causing cerebral infarctions of varioussize and localization. A significant prevalence in the number ofatherosclerotic plaques in the cerebral arteries, including thosecausing stenosis of the lumen by 50% or more, was found in thecase of T2DM compared to cases without T2DM. Cerebral infarctionsin T2DM were mostly of the multiple nature that wasdetermined by a combination of fresh or organizing extensive,large or medium, infarction with one/several organized medium,small deep, and small surface infarctions. More severe atherosclerosisof the cerebral arteries in T2DM caused a higher rateof infarctions due to occlusive atherothrombosis, arterio-arterialembolism, and tandem atherostenosis in these patients comparedto cases without T2DM. In the absence of T2DM, infarctionsoccurred more often due to embolism of the cerebral arteriesfrom the heart with coronary heart disease compared to caseswith T2DM.

Keywords

• ischemic stroke
• type 2 diabetes mellitus
• atherosclerosis of the cerebral arteries
• cerebral infarction