This 67-year-old female was transferred to the hospital from a nursing home in a comatose state. Physical findings on examination were compatible with brain stem infarction. On the fourth hospital day, an electrocardiogram revealed changes compatible with anterior myocardial infarction. The patient remained comatose with quadriplegia and expired on the 16th hospital day.  == Autopsy Findings == Examination of the brain revealed extensive infarction involving the midbrain and cerebellum with complete occlusion of the upper one-half of the basilar artery; there was also extensive coronary artery atherosclerosis. A large aneurysm of the left ventricle was present; this was filled with mural thrombus. Extensive infarction of the lateral and posterior portions of the left ventricular wall toward the base of the heart was also found.

* [http://peir.path.uab.edu{{SERVER}}/library/index.php?/tags/424-mural_thrombus PEIR Digital Library: Mural Thrombus Images]