Japanese Journal of Stroke

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Arteriosclerosis of intracerebral arteries in Japanese people is more severe compared to that of American or European people in which sclerosis of extracranial cerebral arteries (carotid arteries) is more advanced. This causes a different mechanism of transient ischemic attack and different incidences of vascular dementia. In the aged average 80 years old, macroscopic cerebral vascular pathology is found in 83.9% by autopsy, and low density on CT was noted in 19.6% in apparently healthy cases.
I propose a new classification of ischemic cerebral diseases, because it is not reasonable that the same vascular pathology is called by different disease entities, such as cerebral infarction and RIND, according to the severity of pathology. It may be adequate to name cerebral infarction -0, cerebral infarction-1, or -2, depending upon the existence of clinical symptoms or CT (MRI) findings. In this classification, the name of disease suggests the grade of pathology, clinical symptoms or prognosis, in some degree. In early stage of acute severe brainstem hemorrhage and severe ischemia, EEG shows special findings called as α-coma & β-coma, respectively. EEG is moderately asymmetric in cases with aphasia.
The number and size of macroscopic infarction is paralleled significantly with the incidence of dementia. It may be worth while to study prevention of senile demention by administration of cerebral vasodilators or cerebral metabolic activators in aged volunteers.

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