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Old Infarct
Etiology

Infarcts are due to the occlusion of an artery of the Circle of Willis or one of its branches or a vein by a thrombus or embolus.
Pathogenesis

Atherosclerosis is the major cause of cerebral vascular disease causing thickening and partial or complete occlusion of arterial lumina leading to thrombosis, due to low flow or sudden expansion of the arteriosclerotic plaque by hemorrhage or rupture of the plaque.
Emboli arise from diseases of the heart with thrombi on abnormal heart valves or mural thrombi over areas of transmural or subendocardial myocardial infarcts.,
Epidemiology

Cerebrovascular disease is the third leading cause of death after heart disease and cancer.
General Gross Description

Old infarcts appear as cystic spaces of varying size, depending on the size of the artery occluded, which contain portions of blood vessels and glial fibers.
•Examples:
Small Old Cerebral Infarcts
General Microscopic Description

Microscopically appear as a cyst containing blood vessel remnants and macrophages
The surrounding tissue shows a reactive and fibrillary astrocytosis since astrocytes are the scar forming cell as well as the stromal cell in the CNS.
May also show some loss of myelinated fibers and neurons in the surrounding tissue.
•Examples:
Old Cerebral Infarct (low power) Old Cerebral Infarct (low power) Old Cerebral Infarct (high power) Old Cerebral Infarct (high power) Old Cerebral Infarct (high power)
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1309-1311.
Poirer J et.al. Manual of basic neuropathology. Philadelphia: Saunders, 1990, pp.87-92.

For Most Current Information Search Medline at National Library of Medicine
This link will directly take you to the relevant new literature
Old Infarct
Synopsis by: M.L. Grunnet M.D. (TX2000M54750)[29]
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