Cardiac Disorders Predisposing to Embolic Stroke

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Abstract
Data from 4,558 consecutive complete necropsies in patients 16 years of age or older were analyzed to ascertain the influence of certain variables upon the frequency of embolic encephalomalacia. Embolic lesions of the central nervous system occurred more commonly in the female, regardless of age, race, diabetic status, nutritional status or heart size, partly because the cardiovascular lesions responsible for embolic dissemination were more common in women. While affecting only a small percentage of patients at any age, cerebral embolism assumes more importance in strokes of young adulthood. Embolic infarcts demonstrate a predilection for cerebral and cerebellar cortical locations via the long circumferential arterial branches and tend to spare the parasagittal perforating branches supplying the brain stem and diencephalic nuclei. Certain cardiac states predispose to cerebral embolism. Patients with endocarditis show the greatest risk of embolic lesions, although patients with rheumatic valvular disease of the left heart and mural thrombi of the left ventricle produce numerically more cases of embolic encephalomalacia because these conditions occur far more often than the endocardidites.

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