Hypotensive symmetrical hemorrhagic necrosis of the basal ganglia and brain stem.

A series of 9 cases are described in which symmetrical hemorrhagic necrosis was identified in multiple areas of the basal ganglia and brain stem following episodes of intractable hypotension. Such a pattern of brain stem and deep grey structure involvement in global circulatory insufficiency has only been occasionally described. These pathologic changes may represent terminal zone ischemic necrosis of the small paraxial perforating arteries of the brain.