Anstrom John A, Brown William R, Moody Dixon M, Thore Clara R, Challa Venkata R, Block Steven M
Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina 2715.7, USA.
Pediatr Neurol. 2004 Jan;30(1):46-53. doi: 10.1016/s0887-8994(03)00404-1.
The germinal matrix contains a concentrated network of blood vessels. The unusual structural qualities of these vessels are implicated as a factor underlying the high incidence of hemorrhage that occurs in the germinal matrix of prematurely born neonates. The present study is a histologic analysis of an postmortem examination series of brains collected from neonates born between 23 weeks gestation and term and is designed to determine if subependymal veins can be recognized in neonates born at the limits of viability, approximately 23 weeks gestation. Alkaline phosphatase histochemistry is used to differentiate cerebral afferent from efferent vessels. The results demonstrate that precursors of the subependymal veins can be recognized as early as the twenty-third gestational week. These veins increase progressively in diameter from 23 weeks to term, but the wall of the veins, which at early stages consists of endothelial cells only, does not thicken until after postconception week 36. Thus in all premature neonates, including the youngest capable of independent existence, the subependymal veins are present and appear vulnerable to rupture. These data support our suggestion that the structural immaturity of these veins in premature neonates is causally related to the high incidence of germinal matrix hemorrhage in these patients.
生发基质包含密集的血管网络。这些血管不同寻常的结构特性被认为是早产新生儿生发基质出血高发的一个潜在因素。本研究是对一系列从妊娠23周至足月出生的新生儿尸体解剖大脑进行的组织学分析，旨在确定在约妊娠23周、处于存活极限的新生儿中是否能识别出室管膜下静脉。碱性磷酸酶组织化学用于区分脑传入血管和传出血管。结果表明，室管膜下静脉的前体最早在妊娠第23周即可被识别。这些静脉直径从23周开始逐渐增大直至足月，但静脉壁在早期仅由内皮细胞组成，直到孕后36周才增厚。因此，在所有早产新生儿中，包括最年幼的能够独立生存的新生儿，室管膜下静脉都存在且似乎易破裂。这些数据支持了我们的观点，即早产新生儿中这些静脉的结构不成熟与这些患者生发基质出血的高发存在因果关系。
