Subinsular vascular lesions: an analysis of 119 consecutive autopsied brains
Subinsular vascular lesions: an analysis of 119 consecutive autopsied brains
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DOI：
10.1111/j.1468-1331.2006.01567.x
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发表时间：
2007-01-01
影响因子：
5.1
通讯作者：
Miki, Y.
中科院分区：
文献类型：
--
作者：
Tomimoto, H.;Lin, J.;Miki, Y.
红色的大脑构成了一个功能上有趣的复杂的多功能活动。我们检查了119例连续尸检患者的岛叶下区域，因为在该区域的磁共振诊断中经常观察到T2高信号病变。患者在神经内科病房住院，55例（46%）被诊断为脑血管疾病，57例（48%）被诊断为其他神经系统疾病，7例（6%）被诊断为非神经系统疾病。白色物质的脱髓鞘通过Kluver-Barrera染色切片的计算机辅助图像分析半定量为纤维密度评分（染色面积/总面积百分比）。星形胶质细胞增生通过免疫组化胶质细胞酸性蛋白进行评估。病变分析显示29例患者（24%）血管周围间隙扩张，27例患者（23%）脱髓鞘（纤维密度评分低于平均值-1 SD），6例患者（5%）裂隙状病变，1例患者（1%）腔隙性梗死和1例患者（1%）脑出血。两名皮质下缺血性血管性痴呆患者的组织学-放射学比较显示岛叶下高信号、脱髓鞘、神经胶质增生和血管周围间隙扩张之间存在对应关系。这些结果表明，岛叶下病变很少意味着局灶性血管病变，并包括脱髓鞘，神经胶质增生和扩张的血管周围空间。
The insula of Red constitutes a functionally intriguing complex of the brain related to multifunctional activities. We examined the subinsular region in 119 consecutively autopsied patients, as T2 hyperintense lesions are frequently observed in magnetic resonance diagnosis of this region. The patients were admitted in neurology wards and were diagnosed as having cerebrovascular disease in 55 patients (46%), other neurological diseases in 57 patients (48%) and non-neuro logical diseases in seven patients (6%). Demyelination of the white matter was semi-quantified as a fiber density score (percent stained area/total area) with computer-assisted image analysis on Kluver-Barrera-stained sections. Astrogliosis was assessed by immunohistochemistry for glial fibrillary acidic protein. The lesion analysis showed a dilated perivascular space in 29 patients (24%), demyelination (fiber density score less than the mean - 1 SD) in 27 patients (23%), slit-shaped lesion in six patients (5%), lacunar infarction in one patient (1%) and cerebral hemorrhage in one patient (1%). A histologic-radiologic comparison in two patients with subcortical ischemic vascular dementia showed correspondence between subinsular hyperintensities, and demyelination, gliosis and a dilated perivascular space. These results indicate that subinsular lesions rarely signifies focal vascular lesions, and are consisted of demyelination, gliosis and a dilated perivascular space.