Apoptosis normally proceeds in an orderly manner as part of natural cell turnover and development, but that's not the only path to death. A quick influx of calcium ions, or extreme oxidative stress, as happens in cases of stroke, heart attack, or other ischemic events, can cause mitochondria to swell and burst, releasing necrotic mediators. The path that cells take appears intimately linked with the permeability of mitochondrial membranes.
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Mitochondrial Death Throes
Knockout mice reveal a path to necrosis.
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