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Pathology Central Nervous System 46f8e4ab

A 62-year-old man with a history of poorly controlled hypertension and diabetes presents with sudden onset of weakness. His blood pressure is 200/115 mm Hg, and his pulse is 80 per minute. An X-ray film of the chest demonstrates cardiomegaly and pulmonary edema. A CT scan of the brain reveals intra-parenchymal hemorrhage. The patient becomes unresponsive and eventually expires. Which of the following was the most likely site for cerebral hemorrhage in this patient?

A
Basal ganglia/thalamic area
B
Frontal lobe cortex (cortical layers IV through VI)
C
Medulla
D
Midbrain
High-Yield Explanation
Cerebral hemorrhage causes stroke (apoplexy). Cerebral hemorrhages that occur without trauma are referred to as "spontaneous," although most are related to preexisting vascular lesions (Charcot-Bouchard aneurysms) or are the consequence of long-standing hypertension. Hypertensive intracerebral hemorrhage occurs at preferential sites, which in order of frequency are the basal ganglia-thalamus (65%), pons (15%), and cerebellum (8%). Necrosis of pyramidal neurons of Sommer's sector in the hippocampus (choice E) occurs as a consequence of global anoxia.Diagnosis: Cerebral hemorrhage

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