Abstract
The clinical course and findings on cerebral angiograms and computed tomography (CT) were investigated in 11 cases which died immediately after cerebral infarctions in territories of the internal carotid artery system. When pale infarctions presented high density areas on CT during their clinical course, they were classified as hemorrhagic infarctions. Accordingly, there were 8 cases of pale infarctions and 3 cases of hemorrhagic infarctions.
At first, the clinical course, angiographical findings and CT findings were examined in the 8 cases of pale infarctions. Severe conscious disturbance and hemiplegia emerged immediately after the onset. Angiographically, occlusions in the extra- and intracranial internal carotid artery were found. On the CT, low density areas were found in territories supplied by 2 or more main arteries including a middle cerebral artery. Moreover a midline shift of over 10 mm was seen in the early stage. The duration from onset to death was 4.9 days on the average.
On the other hand, in the 3 cases of hemorrhagic infarctions, the neurological conditions on admission were not so severe as those of pale infarctions, but over a period of time the conditions suddenly deteriorated. The low density areas didn't usually range over a wide area; In fact, two cases had lesions only in the territory of the middle cerebral artery. The duration from onset to death was 9.6 days on the averrage.
