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Updated: Jun 10, 2026

Integrated Photoacoustic, Ultrasound, and Angiographic Tomography (PAUSAT) for NonInvasive Whole-Brain Imaging of Ischemic Stroke
Published on: June 2, 2023
Autopsy approach to stroke
1Department of Neuropathology, Institute of Clinical Neurosciences, Frenchay Hospital, Bristol, UK. seth.love@bris.ac.uk
Insights
Autopsies for stroke patients often overlook crucial brain details. Comprehensive examination is vital for understanding stroke pathology, causes, and clinical implications.
Area of Science:
- Neuropathology
- Vascular Pathology
- Forensic Pathology
Background:
- Stroke is a leading cause of death and disability.
- Autopsies frequently examine brain and relevant tissues cursorily.
- Pathological findings and clinical implications depend on stroke type, location, and cause.
Purpose of the Study:
- To highlight the importance of thorough autopsy examination in stroke cases.
- To outline the diverse pathological findings associated with different stroke types.
- To emphasize the clinical relevance of accurate post-mortem diagnosis in stroke.
Main Methods:
- Review of pathological findings in stroke patients.
- Correlation of autopsy findings with clinical data.
- Discussion of common and uncommon causes of ischemic and hemorrhagic stroke.
- Emphasis on proper autopsy preparation and examination techniques.
Main Results:
- Large ischemic strokes often linked to atherosclerosis or dissection.
- Small cerebral infarcts commonly caused by arteriosclerosis or cerebral amyloid angiopathy (CAA).
- Vasculitides and coagulopathies present varied stroke patterns.
- Subarachnoid hemorrhage primarily from berry aneurysms; parenchymal hemorrhage often due to hypertensive small vessel disease or neoplasms.
- Global brain ischemia can mimic hypoglycemic injury.
Conclusions:
- Adequate stroke autopsy requires meticulous preparation, knowledge of vascular anatomy, and careful gross and histological examination.
- Understanding diverse stroke etiologies is crucial for accurate diagnosis.
- Thorough examination improves understanding of stroke morbidity and mortality.
Abstract:
Stroke is a major cause of morbidity and mortality but the brain and other relevant tissues are often examined only cursorily when stroke patients come to autopsy. The pathological findings and clinical implications vary according to the type of stroke and its location and cause. Large ischaemic strokes are usually associated with atherosclerosis of extracranial or major intracranial arteries but can be caused by dissection. Most small cerebral infarcts are caused by arteriosclerosis or, in the elderly, cerebral amyloid angiopathy (CAA). However, vasculitides and coagulopathies can cause a range of different patterns of ischaemic (and, occasionally, haemorrhagic) stroke. Global brain ischaemia, caused by severe hypotension or raised intracranial pressure, produces damage that is accentuated in certain regions and neuronal populations and may be confused with hypoglycaemic injury. The main cause of subarachnoid haemorrhage is a ruptured berry aneurysm but CAA, arteriovenous malformations and infective aneurysms are occasionally responsible. These can also cause parenchymal brain haemorrhage, although this most often complicates hypertensive small vessel disease. Sometimes the haemorrhage arises from a neoplasm. Performing an adequate autopsy in stroke requires proper preparation, awareness of the likely pathological processes, familiarity with intracranial vascular anatomy, careful gross examination and dissection, and appropriate use of histology.
Related Concept Videos
Ischemic Stroke ll: Pathophysiology
Hemorrhagic Stroke ll: Pathophysiology
Stroke: Introduction and Types
Hemorrhagic Stroke l: Introduction
Ischemic Stroke l: Introduction

