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[Features of the localization and pathogenesis of cerebral infarcts in the carotid bassin of patients with arterial hypertension associated with atherosclerosis].

The authors compared the localization of cerebral strokes and the state of the carotid arteries in 46 patients with arterial hypertension in combination with atherosclerosis. Occlusion of the internal carotid artery was associated with infarcts of various size in the cortex and the subcortical substance of the brain. When there was a good collateral blood flow along the anastomoses of the cerebral surface from the posterior cerebral artery into the system of occluded internal carotid artery, these were small infarcts in the white substance of the frontal lobes which were not lacunar. The major importance in the development of cerebral strokes in cases of occluded internal carotid artery belongs to atherosclerosis. Small deep (lacunar) infarcts develop in cases of complete patency of the carotid arteries and the leading role in their genesis belongs to changes in the intracerebral arteries characteristic of arterial hypertension rather than to atherosclerotic lesion of the major arteries of the head. Thus, localization of cerebral infarctions in arterial hypertension combined with atherosclerosis is determined by the state of the carotid arteries and characteristics of the collateral circulation while any of the diseases may play the leading role in their development.