Ohtoh Takashi, Ono Yasuki, Iwasaki Yuzo, Sakurai Yoshiharu, Nishino Akiko, Arai Hiroaki, Suzuki Hiroyoshi, Namba Yoshio
Division of Pathology, South Miyagi Medical Center, Miyagi, Japan.
Neuropathology. 2003 Sep;23(3):195-8. doi: 10.1046/j.1440-1789.2003.00502.x.
Post-mortem examinations of the circle of Willis in two cases of subarachnoid hemorrhage disclosed a wide spectrum of vasculopathy ranging from a minimal tear between the intima and media, and between the media and adventitia, to complete transmural disruption leading to the formation of pseudoaneurysms. The presence of coexistence of the focal lesions with complete replacement of the entire arterial wall with thick fibrous connective tissues and the vasculopathy was suggestive of the spontaneous repair of recurrent non-traumatic dissection of intracranial arteries. The patients were 58-year-old and 43-year-old females. There was no history of injury to the head or neck in either case. They were hypertensive, but the degree of atherosclerotic changes in the circle of Willis was compatible with age. There was no histological evidence of vasculitis. The role of hypertension and medial mucoid degeneration in the genesis of non-traumatic dissection of intracranial arteries was discussed.
对两例蛛网膜下腔出血患者的 Willis 环进行尸检发现，血管病变范围广泛，从内膜与中膜之间、中膜与外膜之间的微小撕裂，到导致假性动脉瘤形成的完全透壁性破坏。局灶性病变与整个动脉壁被厚纤维结缔组织完全替代并存，且存在血管病变，提示颅内动脉复发性非创伤性夹层的自发修复。患者为 58 岁和 43 岁女性。两例均无头部或颈部受伤史。她们患有高血压，但 Willis 环的动脉粥样硬化改变程度与年龄相符。没有血管炎的组织学证据。讨论了高血压和中膜黏液样变性在颅内动脉非创伤性夹层形成中的作用。
