Compression of Brain Arteries as Pathogenetic Factor for Tissue Necroses and Their Areas of Predilection

In any pathologic condition which leads to increased pressure within the skull, it is necessary to differentiate between the “primary lesion” which causes the pressure increase and “secondary lesions” which may develop as sequelae of the increased pressure. Since Attwater (2) demonstrated that pontine hemorrhages accompanying apoplectic or traumatic cerebral hemorrhages arc secondary in nature, several papers have been published on the subject of secondary lesions, and it has become obvious that vascular compression is the essential factor in their pathogenesis. During the last few years special study of this etiologic mechanism has shown that it is more common than would appear from the literature and that it is obviously the cause of a variety of lesions hitherto unsatisfactorily explained. The present paper gives a survey of the various sites and mechanisms of arterial compression and of the nature and areas of predilection of the resulting lesions.