Vascular Neuropathology
Vascular Neuropathology
What You'll Learn
- The pathology and timeline of ischemic infarction and global hypoxic-ischemic injury
- Hemorrhagic stroke by location — deep (hypertensive) vs lobar (amyloid) — and subarachnoid hemorrhage / aneurysms
- Vascular malformations — AVM, cavernoma, developmental venous anomaly, capillary telangiectasia
- Small-vessel disease — lacunes, cerebral amyloid angiopathy, CADASIL — plus CNS vasculitis and venous thrombosis
This is the neuropathology view — gross, histology and stains for each entity. Clinical management lives in the Vascular clinical notes.
Histologic evolution
| Time | On the slide | Cells |
|---|---|---|
| 0–12 h | No H&E change (cytotoxic edema only) | — |
| 12–24 h | Red (eosinophilic) neurons; pallor | Dying neurons |
| 1–3 d | Neutrophil infiltration; tissue necrosis | Neutrophils |
| 3–7 d | Macrophages digest myelin/debris | Gitter cells (foamy macrophages) |
| 1–3 wk | Liquefaction; reactive gliosis at rim; neovascularization | Macrophages, reactive astrocytes |
| >1 mo | Cystic cavity walled by astrogliosis | Astrocytes |
Histologic evolution
| Type | Location | Vessel pathology / stain |
|---|---|---|
| Hypertensive | Deep: putamen/external capsule > thalamus > pons > cerebellum | Lipohyalinosis / fibrinoid necrosis of penetrating arterioles (classic Charcot-Bouchard microaneurysms) |
| Cerebral amyloid angiopathy | Lobar (cortical/subcortical), elderly/normotensive; recurrent | Aβ in cortical/leptomeningeal vessel walls; Congo red apple-green birefringence |
Continue reading — sign in
The full note has more clinical pearls, tables, and board-focused tips. Free account, no fee.