Degenerative Changes of Neurons in the Perifocal Zone of the Brain in Strokes

Abstract Introduction: Cerebral atrophy typically occurs in both strokes and with aging. Each year, the rate of brain atrophy increases by 0.41% in older individuals. Critical disruptions in cerebral blood flow lead to disturbances in intracellular metabolism in neurons. This results in both cell death and neuronal degeneration. Research Objective: To compare the severity of degenerative changes in the brain in different stroke variants. Materials and Methods: A total of 71 autopsy cases with stroke were examined, including 25 with ischemic stroke (IS), 28 with hemorrhagic stroke (HS), and 18 with IS with hemorrhagic transformation (IS with HT). The material was grouped according to the periods of stroke progression by H.I. Mena et al. (2004) and W. Bradley (2007). A total of 118 histological slides of perifocal brain zone specimens stained with hematoxylin and eosin were examined, measuring neurons, nuclei, and lipofuscin. All protocols were statistically processed. Results: In all stroke groups, the number of cases with neurons exhibiting degenerative changes increased with the progression of the disease. Neuron sizes in the IS with HT group were the smallest. Cell sizes in the IS and HS groups were smaller compared to the control group. Significant differences ( P < 0.05) in neuron nucleus sizes were found between the IS, HS, and IS with HT groups compared to the control group, with the smallest nucleus sizes observed in the IS with HT group. The highest accumulation of lipofuscin was found in the IS with the HT group. Significant differences in lipofuscin accumulation were observed in all three groups: between HS and IS ( P < 0.05), between IS with HT and IS ( P < 0.05), and when comparing IS with HT and HS ( P < 0.05). The most pronounced changes in neurons were observed in the HS and IS with HT groups.