Cerebral microvascular abnormalities in patients with idiopathic intracranial hypertension
Cerebral microvascular abnormalities in patients with idiopathic intracranial hypertension
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DOI：
10.1016/j.brainres.2018.02.017
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发表时间：
2018-05-01
期刊：
影响因子：
2.9
通讯作者：
Eide, Per Kristian
中科院分区：
文献类型：
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作者：
Eidsvaag, Vigdis Andersen;Hansson, Hans-Arne;Eide, Per Kristian
目的：特发性颅内高压（IIH）的特征是颅内压（ICP）升高的症状，例如头痛和视力障碍。我们之前曾报道过，IIH 患者的脑活检显示斑片状星形胶质细胞增生，血管周围星形细胞终足水通道水通道蛋白 4 (AQP4) 的表达增加。方法：本研究旨在调查 IIH 患者脑毛细血管的超微结构变化。我们通过电子显微镜（EM）检查了 10 名 IIH 患者和 8 名参考受试者（患者，非健康个体）的皮质实质活检组织，这些受试者的组织是从其他选择性和必要的脑部手术（癫痫、肿瘤或血管疾病）中获取的。 IIH患者根据典型的临床症状和夜间ICP监测颅内压波幅异常进行诊断。结果：10例IIH患者全部接受分流手术，临床结果良好。电镜显示 IIH 中异常的周细胞过程。 IIH 中基底膜 (BM) 更频繁地显示出退化证据，但 IIH 和参考组织之间的 BM 尺寸和周细胞覆盖范围均没有差异。 BM厚度随着年龄的增加而显着增加。参考个体年龄大于IIH病例：观察结果可能在某种程度上与年龄相关。结论：本研究揭示了IIH患者大脑皮质毛细血管的显着变化，表明微血管改变参与了IIH的演变。 (C) 2018 Elsevier B.V. 保留所有权利。
Aim: Idiopathic intracranial hypertension (IIH) is characterized by symptoms indicative of increased intracranial pressure (ICP), such as headache and visual impairment. We have previously reported that brain biopsies from IIH patients show patchy astrogliosis and increased expression of the water channel aquaporin-4 (AQP4) at perivascular astrocytic endfeet.Methods: The present study was undertaken to investigate for ultrastructural changes of the cerebral capillaries in individuals with IIH. We examined by electron microscopy (EM) biopsies from the cortical parenchyma of 10 IIH patients and 8 reference subjects (patients, not healthy individuals), in whom tissue was retrieved from other elective and necessary brain surgeries (epilepsy, tumors or vascular diseases). IIH patients were diagnosed on the basis of typical clinical symptoms and abnormal intracranial pressure wave amplitudes during overnight ICP monitoring.Results: All 10 IIH patients underwent shunt surgery followed by favorable clinical outcome. EM revealed abnormal pericyte processes in IIH. The basement membrane (BM) showed more frequently evidence of degeneration in IIH, but neither the BM dimensions nor the pericyte coverage differed between IIH and reference tissue. The BM thickness increased significantly with increasing age. Reference individuals were older than IIH cases: observations may to some extent be age-related.Conclusion: The present study disclosed marked changes of the cerebral cortical capillaries in IIH patients, suggesting that microvascular alterations are involved in the evolvement of IIH. (C) 2018 Elsevier B.V. All rights reserved.