Different roles of arteriosclerosis in the rupture of intracranial dissecting aneurysms

Histopathology
N SakataM Mitsumata

Abstract

Although intracranial dissecting aneurysm (IDA) is a newly described variant 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 histopathological findings in seven autopsy cases of IDA. 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 were also 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...Continue Reading

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Citations

Mar 25, 2006·Surgical and Radiologic Anatomy : SRA·Barbara CagnieDirk Cambier
Oct 25, 2006·Neurosurgical Review·Teruhide TakagiJun Yoshida
Aug 30, 2007·Neurocritical Care·Alexander Y ZubkovAlejandro A Rabinstein
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Mar 3, 2006·Acta neurochirurgica·C-H KimD H Han
Sep 18, 2002·Pathology, Research and Practice·Noriyuki SakataMasamitsu Takatama
May 20, 2015·Lancet Neurology·Stéphanie DebetteMarie-Germaine Bousser
Oct 31, 2011·The Neuroradiology Journal·T NakazawaK Nozaki
Apr 9, 2005·American Journal of Physiology. Renal Physiology·Mariana G RoscaMiriam F Weiss

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