HISTOPATHOLOGY OF CEREBRAL ANEURYSMS
HISTOPATHOLOGY OF CEREBRAL ANEURYSMS
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DOI：
10.1001/archneur.1963.00460030056005
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发表时间：
1963-01-01
影响因子：
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通讯作者：
STEHBENS, WE
中科院分区：
文献类型：
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作者：
STEHBENS, WE
本文对50例显示动脉瘤前病变的动脉瘤叉和一系列主要用连续切片技术制备的脑动脉瘤的组织学特征进行了研究。患者的平均年龄为57.1岁，出现了早期子宫肌瘤变化（漏斗状隆起、变薄区域和小外翻）。这些变化可能代表动脉瘤形成的早期阶段，有理由相信在文献中它们与内侧缺损混淆。它们与内弹性膜的严重退行性变化相关，通常在变薄或外翻区域缺乏。变薄或外翻的区域有时似乎影响内侧缺损，有时影响邻近的子分支远端壁。这些缺陷似乎与变薄或外翻有关，而不是引起变薄或外翻。这些早期变化似乎与通常发生在分叉周围的退行性变化密切相关，特别是弹性组织。动脉瘤壁的组织学变化表明其反应与动脉壁相似，可能不是由缺陷组织形成的。动脉壁和囊壁之间的结构差异可能是由于动脉瘤形成时囊壁的巨大扩张造成的。没有证据表明分叉尖端的小血管、原始毛细血管丛的痕迹或炎症过程在动脉瘤的发展中起任何作用。
An investigation was made of the histo-logical features of 50 forks displaying preaneurysmal lesions and of a large series of cerebral aneurysms prepared primarily by the serial section technique. The early aneurysmal changes (funnel-shaped dilatations, areas of thinning, and small evaginations) occurred in patients with a mean age of 57.1 years. The changes probably represent the early stages of aneurysm formation, and there is reason to believe that in the literature they have been confused with medial defects. They were associated with severe degenerative changes in the internal elastic lamina, usually deficient in the area of thinning or evagination. The area of thinning or evagination sometimes appeared to affect the medial defect and sometimes the neighboring distal wall of the daughter branch. The defects appeared to be involved in, rather than to have caused the thinning or evagination. These early changes appeared to be intimately related to degenerative changes usually occurring about the fork, particularly of the elastic tissue. The histological changes in the aneurysm wall indicated that its reactions are similar to those of the arterial wall and that it is probably not formed from defective tissue. The architectural difference between the arterial and the sac wall can probably be accounted for by the enormous expansion of the wall that takes place in aneurysm formation. There was no evidence that small vessels arising from the apex of forks, vestiges of the primitive capillary plexus, or inflammatory processes played any part in the development of the aneurysm.