The Relationship of Cerebral Vessel Pathology to Brain Microinfarcts

Brain Pathol. 2017 Jan;27(1):77-85. doi: 10.1111/bpa.12365. Epub 2016 Apr 14.

Abstract

The relationship of cerebral vessel pathology to brain microinfarcts is not fully understood. We examined associations of cerebral vessel pathology with microinfarcts among community-dwelling persons who came to autopsy. Brain specimens were derived from 1,066 deceased subjects (mean age-at-death = 88 years, 65% women) participating in a cohort study of aging. Microinfarcts were classified by number, age and location. Severity of vessel pathologies was graded semi-quantitatively. Almost a third of subjects (n = 300; 28%) had at least one chronic microinfarct, including 128 cortical only, 120 subcortical only, and 47 with both. Moderate-to-severe atherosclerosis was present in 430 (41%) subjects, arteriolosclerosis in 382 (36%), and amyloid angiopathy in 374 (35%). The odds of one or multiple microinfarct(s) was increased for more severe atherosclerosis (OR =1.22; 95%CI: 1.03-1.45), arteriolosclerosis (OR =1.18; 95%CI: 1.02-1.37) and amyloid angiopathy (OR =1.13; 95%CI: 1.00-1.28). Separately, the odds of subcortical microinfarct(s) was increased for atherosclerosis (OR =1.49; 95%CI: 1.20-1.84) and arteriolosclerosis (OR =1.39; 95%CI: 1.16-1.67) but not amyloid angiopathy; whereas the odds of cortical microinfarct(s) was increased for amyloid angiopathy (OR =1.26; 95%CI: 1.09-1.46) only. While cerebral vessel pathologies are associated with microinfarct burden, atherosclerosis and arteriolosclerosis are associated with subcortical microinfarcts, and amyloid angiopathy with cortical microinfarcts.

Keywords: atherosclerosis; brain; cerebrovascular disease; epidemiology; infarction; pathology.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arterioles / pathology
  • Arteriolosclerosis / pathology
  • Brain Infarction / epidemiology
  • Brain Infarction / pathology*
  • Cerebral Amyloid Angiopathy / pathology
  • Cerebral Arteries / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Intracranial Arteriosclerosis / pathology
  • Male
  • Organ Specificity