The arterial lesions underlying cerebral infarction

The arterial lesions underlying cerebral infarction were reviewed by studying the pathological materials in the National Cardiovascular Center. The major clinical cate‐gories of arterial lesion (i.e. atherothrombotic, cardio‐embolic and lacunar strokes) were reviewed. Arterial lesions underlying striatocapsular infarction were reviewed separately. In order to analyze the mechanisms of the development of cerebral infarction, full postmortem ex‐amination of patients dying shortly after the onset of stroke is necessary. Therefore, arterial lesions observed in acute stroke patients were the topic of this review. Two mech‐anisms are responsible for atherothrombotic stroke: re‐duced perfusion due to obstructive changes in the arteries and embolism. Cardioembolic stroke includes a special clinicopathological entity, cerebral infarction associated with non‐bacterial thrombotic endocarditis. The mechan‐isms of development of lacunar stroke are not studied sufficiently because the analysis of arterial lesions respons‐ible for lacunes requires meticulous effort to examine serial sections of specially prepared specimens. Embolism of the middle cerebral artery (MCA) and abnormalities of the internal carotid artery (ICA) and MCA are responsible for striatocapsular infarction. The author emphasizes the need for postmortem examination of stroke patients, especially those dying shortly after the onset of stroke.