Recurrent cholesterol embolism as a cause of fluctuating cerebral symptoms.

Embolic occlusion of a large cerebral artery commonly results in easily recognized cerebral infarction. When arterioles are involved by small emboli there may be only transient disturbances of neurological function, as, for example, when attacks of monocular blindness occur in association with recurrent retinal artery embolism (Fisher, 1959; Russell, 1961, 1963). A third, less common clinical expression of cerebral embolism is that of a fluctuating but increasing neurological deficit. The present report concerns two cases of this last kind in which multiple embolism of small arteries by cholesterol crystals was demonstrated at necropsy.