Kalaria Raj N, Kalimo Hannu
Wolfson Centre, Institute for Ageing and Health and Department of Psychiatry, Newcastle General Hospital, United Kingdom.
Brain Pathol. 2002 Jul;12(3):337-42. doi: 10.1111/j.1750-3639.2002.tb00448.x.
Non-atherosclerotic cerebrovascular disorders are considered to occur less frequently than those caused by embolic or thrombotic disease. Such sporadic disorders resulting from direct effects on the cerebral or peripheral vasculature include hypertensive small vessel disease, vascular inflammatory conditions, aneurysms and arteriovenous malformations. Remarkably, some of these are also inherited in an autosomal dominant manner and appear to entail degeneration or abnormal differentiation of blood vessel wall elements such as smooth muscle, endothelial cells, pericytes and the perivascular nerve plexus. Two intensively investigated examples of these include the cerebral amyloid angiopathies and distinct primary arteriopathies such as CADASIL. The identification of novel genes associated with the hereditary forms of cerebrovascular disorders has been invaluable to understanding of the pathogenesis and management of sporadic disease.
非动脉粥样硬化性脑血管疾病被认为比由栓塞或血栓形成疾病引起的脑血管疾病发病率更低。这些由对脑或外周血管系统的直接影响导致的散发性疾病包括高血压小血管疾病、血管炎性疾病、动脉瘤和动静脉畸形。值得注意的是,其中一些疾病也是以常染色体显性方式遗传的,并且似乎涉及血管壁成分(如平滑肌、内皮细胞、周细胞和血管周围神经丛)的退化或异常分化。其中两个经过深入研究的例子包括脑淀粉样血管病和诸如大脑常染色体显性动脉病伴皮质下梗死和白质脑病(CADASIL)等独特的原发性动脉病。与遗传性脑血管疾病相关的新基因的鉴定对于理解散发性疾病的发病机制和治疗具有重要价值。