BRAIN - Infarction

The specimen consists of a segment of brain sliced in the coronal plane. The section has been taken somewhat anterior to the Circle of Willis. There is pronounced swelling of the right hemisphere with a central area of softening that involves the wall of the lateral ventricle, internal capsule, basal ganglia and white matter of the parietal lobe. The area of infarction is in the distribution of the right middle cerebral artery.
The patient was admitted for coronary artery vein grafting and had a history of hypertension. Postoperatively he was noted to be paralysed on the right side. His level of consciousness deteriorated and a CT scan showed a recent rightsided cerebral infarct. Death was due to brain stem compression, secondary to cerebral oedema.