Sterpetti A V, Hunter W J, Schultz R D
Department of Surgery and Pathology, Creighton University School of Medicine, Omaha, NE.
J Cardiovasc Surg (Torino). 1991 Mar-Apr;32(2):154-8.
In order to investigate the relationship between carotid plaque morphology and symptoms of cerebral ischemia, a prospective clinicopathological study was performed. Ninety consecutive intact carotid plaques obtained from surgery and 43 carotid plaques from cadavers without symptoms of cerebral ischemia were evaluated. Ulceration and mural thrombus were the only morphologic findings statistically correlated to the presence of hemispheric symptoms (p less than 0.02). Intramural hemorrhage was more common in patients with hemispheric symptoms but this difference was not statistically significant (p = 0.31). Plaque causing high degree stenosis had a higher incidence of intramural hemorrhage (p = 0.04) and ulceration (p less than 0.02). Ulceration of plaque plays a major role in the onset of hemispheric symptoms. The results of our study support the hypothesis that in the majority of the cases, hemispheric symptoms are embolic in nature.
为了研究颈动脉斑块形态与脑缺血症状之间的关系，我们进行了一项前瞻性临床病理研究。对连续90例手术获取的完整颈动脉斑块以及43例来自无脑缺血症状尸体的颈动脉斑块进行了评估。溃疡和壁内血栓是仅有的与半球症状存在统计学相关性的形态学表现（p<0.02）。壁内出血在有半球症状的患者中更常见，但这种差异无统计学意义（p=0.31）。导致高度狭窄的斑块壁内出血（p=0.04）和溃疡（p<0.02）的发生率更高。斑块溃疡在半球症状的发作中起主要作用。我们的研究结果支持这样的假说，即在大多数情况下，半球症状本质上是栓塞性的。
