Zubkov A Y, Ogihara K, Bernanke D H, Parent A D, Zhang J
Department of Neurosurgery, University of Mississippi Medical Center, Jackson, Mississippi 39216-4505, USA.
Surg Neurol. 2000 Mar;53(3):260-6. doi: 10.1016/s0090-3019(99)00187-1.
Cerebral vasospasm after subarachnoid hemorrhage is a prolonged contraction that leads to cerebral ischemia or infarction. Morphological studies of cerebral arteries during vasospasm have shown extensive necrosis of smooth-muscle cells and desquamation and dystrophy of endothelial cells. The mechanism of cellular death is unknown.
We report an observation of apoptotic changes in the cerebral arteries of a patient who died after suffering severe cerebral vasospasm caused by aneurysmal rupture. Subarachnoid hemorrhage and cerebral vasospasm were confirmed by computed tomography scanning and angiogram. Histological and immunohistological examinations for apoptosis were performed in cerebral arteries. For control, the arteries from another patient, who died of trauma without head injury, were used.
Corrugation of the internal elastic lamina and increased amounts of connective tissue was demonstrated by light microscopy. Apoptotic changes, characterized by condensation of chromatin of the nucleus and detachment from the basal membrane, were found on transmission electron microscopy in endothelial cells. Terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick end labeling reaction revealed positive staining of the nuclei of the endothelial cells.
This study demonstrates that apoptosis occurred in the cerebral arteries in a patient who died of cerebral vasospasm. The possible role of apoptosis in cerebral vasospasm is discussed.
蛛网膜下腔出血后脑血管痉挛是一种导致脑缺血或梗死的持续性收缩。血管痉挛期间脑动脉的形态学研究显示平滑肌细胞广泛坏死以及内皮细胞剥脱和营养不良。细胞死亡的机制尚不清楚。
我们报告了一例因动脉瘤破裂导致严重脑血管痉挛后死亡患者脑动脉凋亡变化的观察结果。通过计算机断层扫描和血管造影证实了蛛网膜下腔出血和脑血管痉挛。对脑动脉进行了凋亡的组织学和免疫组织学检查。作为对照，使用了另一名死于无头部损伤的创伤患者的动脉。
光镜检查显示内弹性膜皱缩和结缔组织量增加。透射电子显微镜在内皮细胞中发现了以细胞核染色质凝聚和从基底膜脱离为特征的凋亡变化。末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记反应显示内皮细胞核呈阳性染色。
本研究表明死于脑血管痉挛的患者脑动脉发生了凋亡。讨论了凋亡在脑血管痉挛中的可能作用。
