Kalashnikova L A, Sakharova A V, Dobrynina L A, Chaĭkovskaia R P, Nazarova M A, Mir-Kasimov M F, Protskiĭ S V, Shchipakin V L
Zh Nevrol Psikhiatr Im S S Korsakova. 2011;111(7):54-60.
Spontaneous cerebral artery dissection is a common cause of ischemic stroke in young adults and children. Dissection is often related to arterial wall weakness the cause of which is unknown. An aim of the present paper was to carry out an electron microscopic study of skin arteries and arterioles in patients with ischemic stroke caused by cerebral artery dissection. Skin biopsy samples from 3 patients (2 men and one women, 15, 25 and 43 years of age, respectively) were studied. Electron microscopy revealed changes of endothelial, smooth muscle cells and fibroblasts in the skin microvessels. These changes included the decrease in the number of mitochondria and their alterations (vacuolization, destruction of the cristae, the presence of the needle-shaped crystals and crystal-like inclusions) and swelling of the endoplasmic reticulum. Some of these changes were characteristic of mitochondrial diseases. The changes in the extracellular matrix (thickening of the subendothelial layer and deposition of microcalcificats) were also detected. It is assumed that the mitochondrial cytopathy found in the skin microvessels may be also present in large cerebral arteries. This could underlie dysplastic changes in the cerebral artery wall and predispose to its dissection.
自发性脑动脉夹层是年轻成年人和儿童缺血性卒中的常见病因。夹层常与动脉壁薄弱有关，但其病因尚不清楚。本文的目的是对脑动脉夹层所致缺血性卒中患者的皮肤动脉和小动脉进行电子显微镜研究。研究了3例患者（2例男性和1例女性，年龄分别为15岁、25岁和43岁）的皮肤活检样本。电子显微镜检查发现皮肤微血管内皮细胞、平滑肌细胞和成纤维细胞有变化。这些变化包括线粒体数量减少及其改变（空泡化、嵴破坏、针状晶体和类晶体包涵体的存在）以及内质网肿胀。其中一些变化是线粒体疾病的特征。还检测到细胞外基质的变化（内皮下层增厚和微钙化沉积）。据推测，在皮肤微血管中发现的线粒体细胞病变可能也存在于大脑大动脉中。这可能是脑动脉壁发育异常变化的基础，并使其易于发生夹层。
