Cerebral microinfarcts: the invisible lesions.
Cerebral microinfarcts: the invisible lesions.
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DOI：
10.1016/s1474-4422(11)70307-6
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Greenberg SM
中科院分区：
文献类型：
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作者：
Smith EE;Schneider JA;Wardlaw JM;Greenberg SM
多项以人群为基础的放射学和病理学研究证实，小但仍可见的腔隙梗死与认知能力下降之间存在关联。对大脑切片的显微镜检查显示，微梗塞甚至更小，但数量更多，这是目前综述的重点。这些损害通常是由小血管病变引起的，例如动脉硬化或脑淀粉样血管病。在依赖常规结构MRI的临床-放射相关性研究中，它们通常不会被发现，尽管最大的急性微梗塞可能可以通过弥散加权成像检测到。鉴于其数量多且分布广泛，微梗塞可能直接扰乱重要的认知网络，从而解释一些与常规MRI可见的病变相关的神经功能障碍，如腔隙梗塞和脑白质高信号。标准化的神经病理评估标准和生命中非侵入性检测手段的发展将是了解微观上看不见的微梗塞的原因和后果的重要步骤。
The association between small but still visible lacunar infarcts and cognitive decline has been established by multiple population-based radiological and pathological studies. Microscopic examination of brain sections reveals even smaller but substantially more numerous microinfarcts, the focus of the current review. These lesions often result from small vessel pathologies such as arteriolosclerosis or cerebral amyloid angiopathy. They typically go undetected in clinical-radiological correlation studies that rely on conventional structural MRI, though the largest acute microinfarcts may be detectable by diffusion-weighted imaging. Given their high numbers and widespread distribution, microinfarcts may directly disrupt important cognitive networks and thus account for some of the neurologic dysfunction seen in association with lesions visible on conventional MRI such as lacunar infarcts and white matter hyperintensities. Standardized neuropathological assessment criteria and development of non-invasive means of detection during life would be major steps towards understanding the causes and consequences of the otherwise macroscopically invisible microinfarct.