Abstract
Cardiac thrombosis has been generally considered to be a major origin of cerebral embolism in Japanese population. With the recent increase of severe atherosclerosis, it was expected that different opinions concerning the source of cerebral embolus might be risen. Is the real source of the emboli just as generally assumed?
With the object of elucidating this problem, macroscopical as well as microscopical investigations were carried out on the hearts, aortas, carotid arteries, cerebral arteries and brains collected from 30 autopsy cases ranging from 43 to 97 years old in age, who died from cerebral embolism in the period from 1978 through 1983.
The results were as follows : A considerable number of arteriogenous emboli (6 in 30) were found besides cardiogenous ones (16 in 30) in Japanese patients with cerebral embolism. This was especially frequent in both advanced aged autopsy and clinically hypertensive cases (p<0.01). It was also detected that many of arteriogenous emboli were derived from thrombosis induced on atherosclerotic lesions.
As ulcer and thrombosis associated with severe atherosclerosis could often become the sources of arteriogenous emboli, total number of their foci were counted in all the present cases. Their frequency distributions were as follow : Many of them were observed not only in the carotid sinus (10), well known in this regard, but also in the proximal brachiocephalic artery (11), ascending aorta and aortic arch (13), the right and left proximal segments of common carotid (7), subclavian (8) and vertebral arteries (1). All these lesions were regarded as important sources of emboli.
Clinicopathologically, the average age of cardiogenous cerebral embolism cases at death was 65 ± 12 years old and that of arteriogenous 76 ± 11. The mean value for the hematocrits in the blood of these embolism cases patients were 44.5% which was higher than that of 70 year-old control (p<0.01).
