Clinical characteristics of pathologically proved cholesterol emboli to the brain

Cholesterol emboli (CE) to the brain are an important but often unrecognize d cause of stroke. The authors reviewed 29 cases of brain CE identified on autopsy. Most patients were elderly (mean age, 74 years) and presented with encephalopathy and acute renal failure. Ten patients developed symptoms sp ontaneously, 19 after a procedure involving manipulation of the aorta. Brai n imaging revealed multiple, small ischemic lesions and border zone infarct s in 11 of 17 patients. Pathology in most patients demonstrated multiple CE mixed with emboli of other types.