Deutsches Zentrum für Neurodegenerative Erkrankungen-DZNE Magdeburg, Germany.
J Neurol Sci. 2012 Nov 15;322(1-2):71-6. doi: 10.1016/j.jns.2012.06.013. Epub 2012 Jul 23.
Cerebral small vessel disease (CSVD) is a chronically proceeding pathology of small brain vessels associated with white matter lesions, lacunar infarcts, brain atrophy and microbleeds. CSVD leads to slowly increasing cognitive and functional deficits but may also cause stroke-like symptoms, if vessels in critical brain areas are affected. Spontaneously hypertensive stroke-prone rats (SHRSP) exhibit several vascular risk factors, develop infarcts and hemorrhages and therefore represent a relevant model for the study of CSVD. Using this animal model, we recently demonstrated that intravasal accumulations of erythrocytes, we interpreted as stases, stand at the beginning of a pathological vascular cascade. After stases microbleeds occur, which are followed by reactive microthromboses. Bleeds and thromboses finally cause hemorrhagic infarcts. Immunohistochemical stainings show, that plasma proteins like IgG are deposited in the walls of vessels affected by stases. Further, we found small clots and thread-shaped aggregations of thrombocytes as well as thread-shaped structures of von Willebrand-Factor within stases. Thus, we conclude that blood-brain barrier damages occur in the neighborhood of stases and stases seem to be associated with a restricted activation of blood coagulation without formation of obstructive thromboses. Finally, we demonstrate that small vessel damage rarely appears in the cerebellum. Even animals with multiple cerebral infarcts may be free of any cerebellar vascular pathology.
脑小血管病（CSVD）是一种与脑白质病变、腔隙性梗死、脑萎缩和微出血相关的小脑血管慢性进行性病变。CSVD 导致认知和功能逐渐出现缺陷，但如果关键脑区的血管受到影响，也可能导致类似中风的症状。自发性高血压脑卒中易患大鼠（SHRSP）表现出多种血管危险因素，会发生梗死和出血，因此是研究 CSVD 的一个相关模型。使用该动物模型，我们最近证明，血管内红细胞的积聚，我们解释为停滞，是病理血管级联反应的开始。停滞之后会发生微出血，随后会发生反应性微血栓形成。出血和血栓最终导致出血性梗死。免疫组织化学染色显示，像 IgG 这样的血浆蛋白沉积在受停滞影响的血管壁中。此外，我们还在停滞中发现了小凝块和血小板的线状聚集物，以及 von Willebrand 因子的线状结构。因此，我们得出结论，在停滞的附近发生了血脑屏障损伤，并且停滞似乎与凝血的受限激活相关，而没有形成阻塞性血栓。最后，我们证明小血管损伤很少出现在小脑。即使有多个脑梗死的动物也可能没有任何小脑血管病理学。
