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Cerebro-spinal infarction caused by atheromatous emboli
Acta Pathologica Japonica
|July 1, 1985
Summary
Cholesterol emboli rarely affect the central nervous system but can cause cerebro-spinal infarction. Aortic procedures may dislodge these atheromatous materials, increasing neurological risk in elderly patients with hypertension and diabetes.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pathology
Background:
- Cholesterol embolization commonly affects abdominal organs but is infrequent in the central nervous system (CNS).
- Atheromatous emboli are a significant cause of cerebro-spinal infarction, particularly in elderly individuals with comorbidities.
Purpose of the Study:
- To investigate the morphological characteristics of atheromatous embolization to the CNS.
- To identify risk factors and iatrogenic causes of cholesterol emboli in the CNS.
Main Methods:
- Morphological investigation of 14 cases with atheromatous emboli in the CNS.
- Analysis of 800 consecutive autopsy cases to determine the prevalence of atheromatous emboli.
Main Results:
- Cerebro-spinal infarction occurred in 11 of 14 cases (78.6%).
- Aortic procedures (cardiac catheterization, intra-aortic balloon pumping, bypass graft surgery) were implicated in 5 cases.
- Patients were elderly (mean age 70.1 years) with hypertension (78.6%) and diabetes mellitus (42.8%).
- Aortic aneurysms, particularly aortic arch aneurysms, were prevalent (71.4%).
Conclusions:
- Atheromatous embolization to the CNS, though rare, carries a high infarction rate.
- Aortic mechanical procedures pose a risk for dislodging atheromatous material, leading to CNS infarction.
- Management of atherosclerosis and careful consideration during aortic interventions are crucial to prevent CNS complications.