The patient was a 51-year old woman who had a cerebro-vascular accident resulting in a left hemiplegia 2 years prior to death. At necropsy, she had severe generalized atherosclerosis and an old left ventricular myocardial infarct with an overlying mural thrombus.
A coronal section of the cerebral hemispheres shows irregular cystic cavities in the territory of distribution of the right middle cerebral artery. The cavities of the infarct have irregular, yellow walls and show partial collapse. There is compensatory dilatation of the left lateral ventricle. On the posterior aspect, the arteries below the mammillary bodies were moderately atheromatous, although this is difficult to visualise macroscopically.
Because of the underlying history of myocardial disease with the presence of the mural thrombus, it is assumed that her cerebral infarct was probably caused by a thromboembolus.