CASE HISTORY

Had a stroke two years ago from which she recovered, but with some left side paresis. Has had headaches and giddiness since. 2.5 months ago had a sore throat. Just before admission, she had a cerebral attack. Found to be semi-comatose. BP 210/140. Heart enlarged to left. Left side hemiparesis. Well marked arteriosclerosis. Cerebrospinal fluid blood stained.

PATHOLOGY

The specimen consists of the abdominal aorta with the common part of the internal and external iliac arteries. The aorta is slightly dilated, the iliac arteries greatly so. The specimen shows numerous yellow and white patches of nodular atheroma, and there are several small ulcerated patches on the intimal surface of the aorta. In addition, a larger ulcerated patch on the aorta is covered by an adherent ante-mortem thrombus, measuring 5.5cm x3cm. The thrombus does not completely fill the lumen, however, the lumen of the lower part of the right common iliac artery, and extending down the right internal and external iliac arteries. The whole picture is characteristic of advanced atheroma of the aorta. There is a considerable amount of calcification.