There are few chapters in neuropathology of wider practical interest than that of hypertensive disease of the brain. This is mainly because arterial hypertension is a frequent associate of cerebrovascular accidents. The occurrence of massive hemorrhages in cases of arterial hypertension is familiar to clinicians and pathologists alike. With the exception of ruptured aneurysm, arterial hypertension is the condition most frequently associated with cerebral hemorrhage.
The histologic features of hypertensive disease of the brain have been described in detail.1 In all cases typical alterations of the arterioles and capillaries were observed, which consisted of hyaline degeneration and fibrotic thickening of the wall and narrowing or complete obliteration of the lumen. It has been emphasized that these arteriolar alterations are different from those found with arteriosclerosis. The alteration of the nerve parenchyma consisted in diffusely scattered, small foci of old and recent softening, secondary to the arteriolar lesions.
SCHEINKER IM. CHANGES IN CEREBRAL VEINS IN HYPERTENSIVE BRAIN DISEASE AND THEIR RELATION TO CEREBRAL HEMORRHAGE: CLINICAL PATHOLOGIC STUDY. Arch NeurPsych. 1945;54(5):395–408. doi:10.1001/archneurpsyc.1945.02300110079014
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