Single and multiple cerebral infarctions caused by atherosclerosis: morphology and pathogenesis

Abstract

In 139 cases of cerebral infarctions, caused by atherosclerosis,macro- and microscopic investigation of brain and its vascularsystem as well as heart examination were conducted. Infarctionswere located in the anterior circulation in 68 cases, in the posteriorcirculation in 36 cases, in both the anterior and posteriorcirculations in 34 cases. Single extensive, large or mediumcerebral infarction was found in 45 cases. In 93 cases there weremultiple infarcts, located in the vertebrobasilar, carotid or botharterial territories. Infarctions in these cases were mainly smalland medium. Number of cases with single and multiple infarctsin the anterior circulation were nearly the same, while infarcts inthe posterior circulation were predominantly multiple. Maincauses of either single or multiple infarctions in anterior circulationwere obstructive atherothrombosis and cardiogenic thromboembolism,infarctions in posterior circulation were evoked bytandem atherostenosis and obstructive atherothrombosis of thebrain arteries. It has been found that multiple infarctions withinthe one arterial territory mainly have the same mechanism oftheir occurrence. Infarctions of different subtypes were foundmore frequently when located in both the anterior and posteriorcirculations. The most frequent combination regardless ofinfarctions localization was combination of acute atherothromboticinfarct and old hemodynamic infarcts of smaller size.

Keywords

• atherosclerosis
• cerebral infarction
• morphology
• pathogenesis