Clinicopathological Study of Intracranial Fusiform and Dolichoectatic Aneurysms
Clinicopathological Study of Intracranial Fusiform and Dolichoectatic Aneurysms
复制标题
颅内梭形和长扩张动脉瘤的临床病理学研究
作者：
HirofumiNakatomi;HiromuSegawa;AtsushiKurata;YoshiakiShiokawa;KazuyaNagata;HiroyasuKamiyama;KeisukeUeki;TakaakiKirino
背景和目的-颅内梭形动脉瘤在临床上可分为两种不同的亚型：急性夹层动脉瘤和慢性梭形或长扩张动脉瘤。在这2例中，慢性梭形动脉瘤的自然病程和生长机制仍不清楚。方法：回顾性研究了16例慢性梭形动脉瘤患者的连续系列，以阐明患者的临床和神经放射学特征。从8例病例中获得动脉瘤组织，并进行检查，以确定与放射学结果相对应的组织学特征。结果：发现四种组织学特征：（1）内弹性膜（IEL）断裂，（2）增厚的内膜内新生血管形成，（3）壁内出血（IMH）和血栓形成，（4）血栓内新生血管的重复性壁内出血。所有病例均见IEL碎裂，提示这种改变可能是动脉瘤形成的最早过程之一。
Background and Purpose—Intracranial fusiform aneurysms can be divided into 2 clinically different subtypes: acute dissecting aneurysms and chronic fusiform or dolichoectatic aneurysms. Of these 2, the natural history and growth mechanism of chronic fusiform aneurysms remains unknown. Methods—A consecutive series of 16 patients with chronic fusiform aneurysms was studied retrospectively to clarify patient clinical and neuroradiological features. Aneurysm tissues were obtained from 8 cases and were examined to identify histological features that could correspond to the radiological findings. Results—Four histological features were found: (1) fragmentation of internal elastic lamina (IEL), (2) neoangiogenesis within the thickened intima, (3) intramural hemorrhage (IMH) and thrombus formation, and (4) repetitive intramural hemorrhages from the newly formed vessels within thrombus. IEL fragmentation was found in all cases, which suggests that this change may be one of the earliest processes of aneurysm formati...