Two histological methods for recognition and study of cortical microinfarcts in thick sections
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Updated: Jan 31, 2026

Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Heiko Braak1, Simone Feldengut, Jan Kassubek
1University of Ulm, Center for Biomedical Research, Department of Neurology. heiko.braak@uni-ulm.de.
Abstract:
Cortical microinfarcts are the most widespread form of brain infarction but frequently remain undetected by standard neuroimaging protocols. Moreover, microinfarcts are only partially detectable in hematoxylin-eosin-stained (H and E) 4-10 µm paraffin sections at routine neuropathological examination. In this short report, we provide two staining protocols for visualizing cortical microinfarcts in 100-300 µm sections. For low-power microscopy, the first protocol combines aldehyde fuchsine staining for detection of lipofuscin granules and macrophages with Darrow red counterstaining for Nissl material. The second protocol combines collagen IV immunohistochemistry with aldehyde fuchsine/Darrow red or with erythrosin-phosphotungstic acid-aniline blue staining for detailed study of the capillary network. In the first protocol, microinfarcts are recognizable as radially-oriented funnel-like accumulations of aldehyde fuchsine-positive macrophages. The second protocol recognizes microinfarcts and alterations of the capillary network, at whose center accumulations of dead neurons and aldehyde fuchsine-positive macrophages cluster. In addition, the second protocol permits visualization of abnormalities within the capillary network associated with more recent microinfarcts. Both protocols can be useful for comparing MRI datasets with cortical microinfarcts in corresponding whole brain sections of 100-300 µm thickness.
Insights
New staining methods improve the detection of cortical microinfarcts, small brain lesions often missed by standard imaging. These techniques enhance visualization in thicker brain sections for better neuropathological examination.
Area of Science:
- Neuropathology
- Neuroimaging
- Cerebrovascular Diseases
Background:
- Cortical microinfarcts are common but often undetected by standard neuroimaging.
- Conventional H and E staining of thin sections has limited sensitivity for microinfarcts.
Purpose of the Study:
- To develop and present two novel staining protocols for enhanced visualization of cortical microinfarcts.
- To enable detailed neuropathological examination of microinfarcts in thicker brain sections (100-300 µm).
Main Methods:
- Protocol 1: Aldehyde fuchsine and Darrow red staining for macrophages and Nissl material.
- Protocol 2: Collagen IV immunohistochemistry combined with aldehyde fuchsine/Darrow red or erythrosin-phosphotungstic acid-aniline blue staining for capillary network analysis.
Main Results:
- Protocol 1 identifies microinfarcts as radial accumulations of aldehyde fuchsine-positive macrophages.
- Protocol 2 visualizes microinfarcts, associated capillary network alterations, and clusters of dead neurons and macrophages.
- The second protocol highlights abnormalities in the capillary network of recent microinfarcts.
Conclusions:
- The developed staining protocols significantly improve the detection and characterization of cortical microinfarcts.
- These methods facilitate correlation between MRI findings and neuropathological examination of thicker brain sections.
- Enhanced visualization aids in understanding the pathology of microinfarcts and their vascular associations.
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