We investigated 435 cases of cerebral infarction and hemorrhage (108 were diabetics and 327 were nondiabetics) which were confirmed by computed tomography in the Sumitomo Hospital from 1976 to 1987. Among the 327 nondiabetics, there were 67 cases (20.5%) of hemorrhage and 260 cases (79.5%) of infarction. Among the 108 diabetic patients, there were fewer cases of cerebral hemorrhage, 12 cases (11.1%), and more infarctions, 96 cases (88.9%) than in the nondiabetic patients. Among diabetic patients microangiopathic and neuropathic complications, the ratio of infarctions to hemorrhages was 41 to 8. However in diabetics with neuropathy, the ratio decreased markedly to 24 to 1. These results indicate that the proportion of cerebral hemorrhages to infarctions particularly decreases in diabetic patients with neuropathy.
We have already reported that studies on diabetic rats and humans with autonomic neuropathy have shown impaired catecholamines secretion. We may therefore, conclude that impaired catecholamines secretion may play a role in the decrease of the incidence of cerebral hemorrhage compared to infarctions in diabetic cases.