Liquefactive necrosis is the predominant pattern of necrosis in ischemic brain infarction because:

• A The brain lacks a blood supply and cannot mount an inflammatory response
• B Neural tissue has a uniquely low oxygen demand making it resistant to coagulative change
• C The brain has extensive collateral circulation that prevents complete infarction
• D High lipid content and abundant lysosomal enzymes cause complete enzymatic digestion of brain tissue ✓

Explanation

The brain undergoes liquefactive rather than coagulative necrosis because neurons and glial cells are rich in lipids and lipases, and the central nervous system has abundant lysosomal hydrolytic enzymes relative to structural proteins. This leads to rapid enzymatic digestion converting infarcted tissue into a liquid or semi-liquid material. In contrast, coagulative necrosis in organs like heart and kidney reflects denaturation of cytoplasmic proteins that preserves cellular outlines, since structural protein content outweighs enzymatic activity.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

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Written and medically reviewed by the StethoPrep medical team.