The effect of size, histologic elements, and water content on the visualization of cerebral infarcts

We correlated the radiologic and pathologic examination of 13 human brains, analyzing the size, different histologic elements, and water content in 40 ischemic and hemorrhagic infarcts. Acute infarcts appear in the computerized cranial tomographic (CT) image as low density areas due to high content of fluid, however, a histological-chemical correlation is not concomitant. The addition of blood in hemorrhagic infarcts may result in a normal CT image. Subacute infarcts appear as low density areas, with lower attenuation values due to the presence of large amounts of lipids. Subacute lesions with prominent mineral deposits may be negative on CT scan. Chronic infarcts also appear as low density areas due to cavitation and residual fats. Attenuation values are slightly higher than those of subacute infarcts, possibly due to gliosis. Infarcts smaller than 2 cm in diameter are usually not visualized.