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Neuropathological Study of Acute Severe Cerebral Infarction -Clinical and Experimental Study-


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Title: Neuropathological Study of Acute Severe Cerebral Infarction -Clinical and Experimental Study-
Authors: Shibata, Shobu
Issue Date: 25-Oct-1987
Citation: Acta Medica Nagasakiensia. 1987, 32(1-4), p.61-72
Abstract: The neuropathological findings of acute severe cerebral infarction were analyzed in comparison with four autopsied cases and experimental cerebral infarction in dogs. Four autopsied cases with acute severe cerebral infarction included 1 male and 3 females ranging in age from 57 to 68 years. All patients had histories of hypertension and cardiac disease. Three of the 4 patients died within 7 days after clinical evidence of infarction. In 3 patients, angiography showed an occlusion of internal carotid or middle cerebral artery and a recanalization. A CT-scan was performed on two of these 3 patients and on the one who survived 22 days. Experimental cerebral infarction was induced in 165 dogs by injecting one or two silicone cylinders through the cervical internal carotid artery. The embolus was found to have obstructed the main trunk of the middle cerebral artery in 102 dogs. And only 47 dogs or 50 per cent, had large hemispheric infarction occupying more than 50 per cent of the hemisphere involving the basal ganglia, cerebral cortex and white matter. The results obtained were as follows : 1. Pathologic changes of the autopsied and experimental cases resembled each other closely. The gross specimens and histologic sections were reviewed, showing that the massive hemorrhage was localized in the basal ganglia and the petechial hemorrhage in the corticomedullary junction of the infarct affecting the hemisphere in the middle cerebral artery distribution. It is suggested that the massive hemorrhage may be caused by the disruption of the arteriole in the perforating arterial terminal zone, and the petechial hemorrhage by the disruption of the venule in the cortical arterial terminal zone. 2. The CT of the patient with fatal cerebral infarction showed only large low-density area with a negative contrast enhancement which occupied the affected hemisphere almost entirely and which also showed remarkable mass effects. Acute severe cerebral infarcts appeared as low density areas, with lower attenuation values due to the presence of large amounts of edema fluid, therefore the addition of blood in hemorrhagic infarct of the basal ganglia and the corticomedullary junction may be negative on CT scan.
Keywords: acute severe cerebral infarction / autopsied cases / experimental cases / CT findings / pathology
URI: http://hdl.handle.net/10069/17510
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 32, No. 1-4

Citable URI : http://hdl.handle.net/10069/17510

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