Brain infarction in the internal carotid artery bed in atherosclerosis

: Gross and microscopic studies of the brain and its vascular system were conducted in 139 autopsy brain infarction specimens in atherosclerosis. Of them, 102 specimens displayed 193 infarctions of various extent and duration in the bed of the internal carotid artery (ICA) and its branches. The infarctions were solitary and multiple in 56 and 46 cases, respectively. The revealed infarctions were extensive (n = 22), large (n = 26), medium-sized (n = 86), small in-depth (n = 38), and small superficial (n = 21). The occurrence of great (extensive, large, and medium-sized) infarctions was found to be pathogenetically associated with atherothrombosis obliterans, cardiogenic or less frequently arterioarterial thromboembolism of ICA and its main branches. Atherosclerotic small in-depth and small superficial infarctions, as well as a number of median-sized infarctions occurred mainly via mechanism of cerebrovascular insufficiency in carotid tandem atherostenosis. The extent and location of brain infarction are greatly influenced by the site of hemodynamic carotid artery atherostenosis or thrombosis, the state of collateral circulation, the structure of the arterial circle of Willis, the state of the heart, etc.