HISTOLOGIC ASSESSMENT OF THE AGE OF RECENT BRAIN INFARCTS IN MAN
HISTOLOGIC ASSESSMENT OF THE AGE OF RECENT BRAIN INFARCTS IN MAN
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DOI：
10.1097/00005072-199309000-00006
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发表时间：
1993-09-01
影响因子：
3.2
通讯作者：
TAPIA, J
中科院分区：
文献类型：
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作者：
CHUAQUI, R;TAPIA, J
为了设计一个基于近期发病脑梗塞显微图像的测年系统，我们对30例尸检病例中31例梗塞进行了组织学检查，涵盖了前4周的演变。在每例病例中，脑血管意外的发生日期均在临床上确定。其中男性13例，女性17例，平均年龄65岁。出血性梗死15例，贫血性梗死16例。根据组织学特征可分为四个时期：第一时期，从第1天到第4天，以嗜酸性神经元和坏死的少突胶质细胞为主，第二时期，从第5天到第7天，与第一时期不同的是出现了巨噬细胞和新形成的血管;第三阶段，从第8天到第14天，显示神经元血影、巨噬细胞、星形胶质细胞增殖、肥大细胞和中性粒细胞缺失;在第四阶段，从第15天到第27天，没有嗜酸性神经元，并且在梗塞的中央部分既没有坏死的少突胶质细胞也没有髓鞘被鉴定。通过评估组织学特征，并准确地将结果与相应的临床数据相关联，我们已经能够描述脑梗死演变的第一个月的四种不同的显微镜模式。目前的研究结果可能被认为是有用的形态学线索，以更好地描述人类脑梗死的早期演变阶段。
In order to design a dating system based on the microscopic picture of brain infarcts of recent onset, we performed the histological examination of 31 infarcts covering the first 4 weeks of evolution in 30 autopsy cases. The date of the cerebral vascular accident was clinically established in every case. There were 13 men and 17 women with a mean age of 65 years. Hemorrhagic infarcts were found in 15 cases and anemic infarcts in 16 cases. Based on the histological features four periods were identified: the first period, from day 1 through day 4, was characterized by the predominance of eosinophilic neurons and necrotic oligodendrocytes; the second period, from day 5 through day 7, differed from the first by the appearance of macrophages and of newly formed blood vessels; the third period, from day 8 through day 14, showed neuronal ghosts, macrophages, astrocytic proliferation, gemistocytes, and absence of neutrophils; and in the fourth period, from day 15 through day 27, there were no eosinophilic neurons, and neither necrotic oligodendrocytes nor myelin in the central portion of the infarct were identified. By assessing the histological features and accurately correlating the findings with the corresponding clinical data, we have been able to describe four distinct microscopic pattems of the first month of evolution of brain infarcts. The present findings may be considered useful morphological clues to better characterize the early evolutional phase of brain infarcts in humans.