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Titolo:
Different roles of arteriosclerosis in the rupture of intracranial dissecting aneurysms
Autore:
Sakata, N; Takebayashi, S; Kojima, M; Masawa, N; Suzuki, K; Takatama, M; Kusumi, Y; Mitsumata, M;
Indirizzi:
Fukuoka Univ, Sch Med, Dept Pathol 2, Jonan Ku, Fukuoka 8140180, Japan Fukuoka Univ Fukuoka Japan 8140180 l 2, Jonan Ku, Fukuoka 8140180, Japan Dokkyo Univ, Sch Med, Dept Pathol 1, Mibu, Tochigi, Japan Dokkyo Univ Mibu Tochigi Japan Med, Dept Pathol 1, Mibu, Tochigi, Japan Gunma Univ, Sch Hlth Sci, Dept Lab Sci, Div Pathol, Maebashi, Gumma 371, Japan Gunma Univ Maebashi Gumma Japan 371 iv Pathol, Maebashi, Gumma 371, Japan Geriatr Res Inst, Maebashi, Gumma, Japan Geriatr Res Inst Maebashi Gumma Japan r Res Inst, Maebashi, Gumma, Japan Nihon Univ, Sch Med, Dept Pathol, Tokyo, Japan Nihon Univ Tokyo JapanNihon Univ, Sch Med, Dept Pathol, Tokyo, Japan
Titolo Testata:
HISTOPATHOLOGY
fascicolo: 4, volume: 38, anno: 2001,
pagine: 325 - 337
SICI:
0309-0167(200104)38:4<325:DROAIT>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
BASILAR ARTERY; SUBARACHNOID HEMORRHAGE; VERTEBRAL ARTERY; PATHOGENESIS; ARCHITECTURE;
Keywords:
intracranial dissecting aneurysm; histopathology; vertebral artery; hypertension; intramural haemorrhage; arteriosclerosis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Sakata, N Fukuoka Univ, Sch Med, Dept Pathol 2, Jonan Ku, 45-1,7 Chome Nanakuma, Fukuoka 8140180, Japan Fukuoka Univ 45-1,7 Chome Nanakuma Fukuoka Japan 8140180 Japan
Citazione:
N. Sakata et al., "Different roles of arteriosclerosis in the rupture of intracranial dissecting aneurysms", HISTOPATHOL, 38(4), 2001, pp. 325-337

Abstract

Aims: Although intracranial dissecting aneurysm (IDA) is a newly describedvariant of the brain aneurysms that affects mainly the vertebrobasilar arterial system, its pathogenesis remains obscure, We aimed to clarify the role of arteriosclerosis in the pathogenesis of IDA based on histopathologicalfindings in seven autopsy cases of IDA. Methods and results: All cases exhibited systemic hypertension or left ventricular hypertrophy. Macroscopically, all cases exhibited subarachnoid haemorrhage. Two types of dissection were recognized in the vertebral artery, Six of seven IDA cases showed a widespread disruption of the entire thickness of the arterial wall with the formation of a dilated pseudoaneurysm, which consisted of thin adventitia (arterial wall disruption type), Medial disruption of the arterial wall and subadventitial dissecting haemorrhage werealso found, resulting in the formation of a false lumen and stenosis of the 'true' lumen of the artery. However, these lesions were connected to the site of rupture of the entire arterial wall. Within 1 day after onset of IDA, the autopsy cases showed formation of fibrin thrombus, marked leucocyte infiltration and necrosis of the arterial wall at the site of the lesion. Cases that survived more than 1 week showed smooth muscle cell proliferation, macrophage accumulation and lymphocytic infiltration in the lesions. These cases showed no atherosclerotic plaque, but non-atherosclerotic fibrocellular intima. The thickness of intima and media was significantly less in the vertebral artery of IDA patients than that of non-IDA patients with systemic hypertension. On the other hand, the remaining case showed severe atherosclerosis with haemorrhage into the lipid core without connection to the arterial lumen (intra-atheromatous plaque haemorrhage type). However, unusual arterioles and neovascularization of the intra-and peri-arterial walls were observed. Conclusions: Our results suggest that disruption of the entire arterial wall may be a critical event in the development of IDA and result in the medial disruption and subadventitial haemorrhage. Non-atheromatous intima mightfunction as a protective factor in arterial wall disruption, On the other hand, atherosclerosis may predispose to intra-atheromatous plaque haemorrhage type of IDA through intramural haemorrhage originating from the newly formed vessels.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 03:29:13