Summary
Of 1721 consecutive autopsies performed on patients over 60 years of age in Tokyo Metropolitan Geriatric Hospital, 550 (32% of all autopsied cases) revealed symptomatic cerebrovascular lesions. Among the 550 patients, intracranial hemorrhage was found in 19%, cerebral infarction in 75%, and coexisting cerebral hemorrhage and cerebral infarction in 6%. Twenty-eight percent of the cerebral infarctions were embolic infarctions of cardiac origin, half of which were caused by nonvalvular atrial fibrillation, and 69% were nonembolic infarctions of cardic origin. Progressive subcortical vascular encephalopathy accounted for 15% of the cerebral infarctions. Two-thirds of all lobar cerebral hemorrhages were amyloid angiopathy-related. Nonvalvular atrial fibrillation is the most important cardiac source of embolic stroke. Progressive subcortical vascular encephalopathy is one of the characteristic features of ischemic lesions, and cerebral amyloid angiopathy is an important cause of lobar cerebral hemorrhage in the aged.
Similar content being viewed by others
References
Aoki N, Horibe H, Kasagi F (1984) International mortality statistics for all causes, cerebrovascular disease, ischemic heart disease and diabetes mellitus 1958–1978. National Cardiovascular Center Research Institute
Cerebral Embolism Task Force (1986) Cardiogenic brain embolism. Arch Neurol 43:71–84
Gács Gy, Mérei FT, Bodosi M (1982) Balloon catheter as a model of cerebral emboli in humans. Stroke 13:39–42
Gilbert JJ, Vinters HV (1983) Cerebral amyloid angiopathy: incidence and complications in the aging brain. I. Cerebral hemorrhage. Stroke 14:915–923
Hachinski VC, Potter P, Merskey H (1987) Leuko-Araiosis. Arch Neurol 44:21–23
Jellinger K, Neumayer E (1964) Progressive subcorticale vasculäre Encephalopathie Binswanger. Eine klinisch-neuropathologische Studie. Arch Psychiat Nervenkrht 205:523–554
Jellinger K (1977) Cerebrovascular amyloidosis with cerebral hemorrhage. J Neurol 214:195–206
Kannel WB, Dawber TR, Cohen ME et al. (1965) Vascular disease of the brain — epidemiologic aspects: The Framingham study. Am J Public Health 55:1355–1366
Lhermitte F, Gautier JC, Derouesné C (1970) Nature of occlusions of the middle cerebral artery. Neurology 20:82–88
Matsumoto N, Whisnant JP, Kurland LT, Okazaki H (1973) Natural history of stroke in Rochester, Minnesota. 1955 through 1969: an extension of a previous study, 1945 through 1954. Stroke 4:20–29
Mohr JP, Caplan LR, Melski JW, Goldstein RJ, Duncan GW, Kistler JP, Pessin MS, Bleich HL (1978) The Harvard cooperative stroke registry: a prospective registry. Neurology 28:754–762
Pessin MS, Hinton RC, Davis KR, Duncan GW, Roberson GH, Ackerman RH, Mohr JP (1979) Mechanisms of acute carotid stroke. Ann Neurol 6:245–252
Steingart A, Hachinski VC, Lau C, Fox AJ, Diaz F, Cape R, Lee D, Inzitari D, Merskey H (1987) Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol 44:32–35
Tomonaga M (1981) Cerebral amyloid angiopathy in the elderly. J Am Geriatr Soc 29:151–157
Tomonaga M, Yamanouchi H, Tohgi H, Kameyama M (1982) Clinicopathological study of progressive subcortical vascular encephalopathy (Binswanger type) in the elderly. J Am Geriatr Soc 30:524–529
Vinters HV (1987) Cerebral amyloid angiopathy. A critical review. Stroke 18:311–324
Vinters HV, Gilbert JJ (1983) Cerebral amyloid angiopathy; incidence and complications in the aging brain. II. The distribution of amyloid vascular changes. Stroke 14:924–928
Whisnant JP, Fitzgibbons JP, Kurland LT, Sayre GP (1971) Natural history of stroke in Rochester, Minnesota, 1945 through 1954. Stroke 2:11–22
Yamanouchi H, Tohgi H, Tomonaga M, Iio M (1981) Computerized tomographic evaluation of chronic ischemic lesions in cerebral white matter. Jpn J Geriatr 18:297–307
Author information
Authors and Affiliations
Additional information
This work was supported in part by Grant-in-Aid for Cooperative Research No. 63304039, The Ministry of Education, Science and Culture, Japan
Rights and permissions
About this article
Cite this article
Yamanouchi, H., Shimada, H. & Kuramoto, K. Subtypes and proportions of cerebrovascular disease in an autopsy series in a Japanese Geriatric Hospital. Klin Wochenschr 68, 1173–1177 (1990). https://doi.org/10.1007/BF01815273
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF01815273