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Heart and vessel pathology underlying brain infarction in 142 stroke patients

Jun Ogata1, Chikao Yutani, Ryoichi Otsubo

  • 1Department of Pathology, National Cardiovascular Center, Osaka, Japan. jogata@hirakataryoiku-med.or.jp

Annals of Neurology
|May 23, 2008
PubMed

Insights

Histopathology reveals that atherothrombotic stroke involves thrombi at cerebral artery plaques, while cardioembolic stroke results from heart or venous thrombi embolizing arteries. This clarifies stroke origins.

Area of Science:

  • Neurology
  • Cardiology
  • Pathology

Background:

  • Ischemic stroke subtypes have distinct underlying pathologies.
  • Understanding these histopathological differences is crucial for effective treatment and prevention.

Purpose of the Study:

  • To determine the histopathological characteristics of cardiac and vascular lesions causing various ischemic stroke subtypes.
  • To differentiate between atherothrombotic and cardioembolic stroke mechanisms.

Main Methods:

  • Postmortem pathological examination of 142 patients who died within 30 days of ischemic stroke onset.
  • Analysis of cardiac and vascular lesions, focusing on thrombus formation and location.

Main Results:

  • Atherothrombotic stroke (17 cases) was linked to thrombi at culprit plaques in cerebral arteries.
  • Cardioembolic stroke (107 cases) was predominantly caused by cardiac or venous thrombi (70% of cases).
  • Lacunar stroke (2 cases), other determined causes (12 cases), and undetermined causes (4 cases) were also identified.

Conclusions:

  • Atherothrombotic strokes typically involve fibrin- and platelet-rich thrombi at cerebral artery plaques.
  • Cardioembolic strokes result from red thrombi originating in the heart or peripheral veins, embolizing cerebral arteries.
Abstract

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