Left cerebral infarct - Erler Zimmer

Left cerebral infarct - Erler Zimmer

Clinical History

The patient, a 51-year-old woman, experienced a cerebrovascular accident resulting in left hemiplegia 2 years before her demise. Upon necropsy, severe generalized atherosclerosis and an old left ventricular myocardial infarct with an overlying mural thrombus were identified.

Pathology

A coronal section of the cerebral hemispheres reveals irregular cystic cavities in the territory of distribution of the right middle cerebral artery. The infarct's cavities have irregular, yellow walls and exhibit partial collapse. Compensatory dilatation of the left lateral ventricle is observed. On the posterior aspect, the arteries below the mammillary bodies were moderately atheromatous, although this is challenging to visualize macroscopically.

Further Information

Given the underlying history of myocardial disease and the presence of the mural thrombus, it is presumed that the cerebral infarct was likely caused by a thromboembolus.