Cerebral Embolism in Cardiac Diseases:The Clinical and Pathological Studies of 56 Cases

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(1) Clinical and pathological findings were studied in 56 cases of cerebral embolism among 1, 029 patients admitted to the Second Medical Department, Tokyo University Hospital from 1941 to 1957.(2) No sexual difference was found (male 30, female 26), (3) The nature of the underlying heart diseases were as follows; mitral stenosis, mitral stenosis and insufficiency, combined valvular disease, sclerotic and hypertensive heart disease, congenital heart disease, S.B.E., and so on.(4) Thirty per cents of 56 cases had multiple embolic episodes. Interval between each episode was within 6 months in about one half of the cases.(5) It was demonstrated that atrial fibrillation was the very important factor as the cause of emboli, and digitalis therapy, congestive failure or size of the heart were not related to the occurrence of cerebral emboli.(6) Paralysis was the most frequent neurological symptom. No dominant laterality was found. Recoveries from paralysis were complete or moderate in 74%.(7) Recovery from mental deterioration was seen in 79%, one half of which restored the consciousness in 24 hours.(8) Many cerebral embolic episodes occurred in valvular heart disease with intracardiac thrombus. On the other hand, many cases of S.B.E. without intracardiac thrombus developed cerebral emboli.(9) The lesions of basal ganglia and internal capsule were found to be most frequent, and the area of middle cerebral artery was involved far more frequently than the other area.
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