[Pathogenesis of cerebral hemorrhage considered in the light of objective lesions in the arteries of the brain (in 226 cases studied by autopsy)].

Conclusions drawn from the post-mortem examination of 226 subjects who died of cerebral haemorrhage are presented. There were slightly more women than men (53%) in the series. Arterial hypertension (68%) was the main cause of death, while renal disease, leukaemia, angioma of the pons, and embolism due to bacterial endocarditis were also observed. The most frequently noted sites are listed. Since cerebral haemorrhage follows the rupture of one or more already damaged deep arteries, as assessment was made of the part played by vascular lesions. 13 cases due to leukaemia and 35 to rupture of aneurysms of the polygon of Willis were discarded. In only 20 cases out of 138 in which convincing microscopic evidence of the vascular situation could be obtained was there an absence of significant alterations. The remaining cases consisted of serious hyalinosis (56%), fibrinoid necrosis (13%), and siderocalciosis (12%). An account is also given of the special pathogenetic conditions applicable to cerebral haemorrhage associated wtih serious gastrointestinal haemorrhage or recent myocardial infarct.