Related Experiment Videos
[Clinico-morphological characteristics of cardiogenic non-bacterial cerebral embolism]
Insights
Heart rhythm disorders are a primary cause of cardiogenic embolisms leading to ischemic stroke. Embolus characteristics determine infarction type, with lysis causing hemorrhagic stroke and stable emboli causing white stroke.
Area of Science:
- Neurology
- Cardiology
- Pathology
Context:
- Ischemic stroke is a leading cause of death and disability.
- Cardiogenic embolisms are a significant cause of ischemic stroke.
- Understanding the origin and characteristics of cerebral emboli is crucial for stroke management.
Purpose:
- To investigate the role of heart rhythm disorders in cardiogenic cerebral embolisms.
- To analyze the relationship between thrombus formation, embolus characteristics, and stroke type.
- To differentiate the clinical manifestations of white versus hemorrhagic cerebral infarction.
Summary:
- Clinical and morphological studies of 194 patients who died during the acute phase of ischemic stroke revealed that heart rhythm disorders are the main cause of cardiogenic embolisms.
- Left atrial thrombus formation was more common with heart rhythm disorders, while left ventricular thrombus formation was more common without them. Embolus content matched the source material, and location was determined by mechanical obstruction.
- Stable emboli typically caused white infarction (with or without hemorrhage), whereas embolus lysis resulted in hemorrhagic infarction or transient ischemic attacks. Hemorrhagic infarction presented with less severe symptoms and neurological regression compared to white infarction.
Impact:
- This study highlights the critical link between cardiac arrhythmias and ischemic stroke etiology.
- Findings provide insights into predicting stroke type based on embolus characteristics.
- Differentiating infarction types aids in understanding clinical presentation and prognosis for stroke patients.
Abstract:
Clinical and morphological studies were carried out in 194 patients who died in the acute period of ischemic brain stroke. Disorders of the heart rhythm were found to play the leading part in the origin of cardiogenic embolisms of cerebral vessels. It has been recorded that left atrial thrombus formation was prevalent in heart rhythm disorders whereas left ventricular was prevalent in lack of those disorders. In different heart diseases complicated by atrial fibrillation and cerebral thromboembolism, the one-third of cases did not show any heart thromboses. The content of embolisms in cerebral arteries corresponded to the material of their source, whereas the site was specified by mechanical obstruction, with no changes in the vascular wall. It has been disclosed that in the majority of cases, stable embolism precipitates white infarction or white infarction with the hemorrhagic component whereas embolus lysis is responsible for hemorrhagic infarction and (or) a transitory ischemic attack. The clinical manifestations of hemorrhagic infarction differ from white infarction in less gravity and regression of the neurological symptomatology.