| Infarct
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Etiology
•Cerebral infarcts are due to occlusion of an artery
by a thrombus or embolus effectively cutting off
nutrients and oxygen to the area fed by the artery.
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Pathogenesis
•The most comman
cause of cerebral infarct is due to
atherosclerosis of cerebral and coronary arteries
which is related to age, smoking, hypertension, serum lipids and
cholesterol, and diabetes.,
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Epidemiology
•Stroke is a common cause of death and disablility
in patients over 55 but can be seen younger individuals
as well.
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General Gross Description
•The brain shows tannish discoloration and swelling as well
as softening in the area of the pale infarct.
•In the hemorrhagic infarct, the grey matter will show
multiple petechial hemmorrhages in the area affected.
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General Microscopic Description
•Microscopically, the cerebral grey and white matter
in the affected area will be pale show vacuolization
at the border between the infarct and intact tissue.
•Within the first 24 hours, a few neutrophils will appear.
•Within three days, macrophages will appear to phagocytose necrotic
tissue and there will be swelling or reactive
change in astrocytes at the border of the infarct
as if to wall it off.
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Clinical Correlation
•Patients with a cerebral infarct (stroke) will
have the
sudden onset of focal neurological deficit such as a
hemiparesis which gets somewhat worse with the
accompanying edema and then stabilizes, unless there has
been a massive stroke with edema, herniation and death.
•After beginning resolution of the infarct, the patients
neurological deficit may improve.
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1309-1311.
• Poirer J et.al. Manual of basic neuropathology. Philadelphia: Saunders, 1990, pp. 79-92.
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| Infarct
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| Synopsis by: M.L. Grunnet M.D. (TX2000M54700)[62]
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