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椎基底动脉延长扩张症作为脑积水和缺血性脑卒中的病因

Dolichoectasia of Vertebrobasilar Arteries as a Cause of Hydrocephalus and Ischemic Cerebral Stroke.

作者信息

Zdravković Miodrag, Kostov Milos, Petrovic Sladjana, Zdravkovic Jovana

机构信息

From the Departments of *Forensic Medicine and †Radiology, Faculty of Medicine, University of Nis; and ‡Private Hospital "Sava Surgery," Nis, Serbia.

出版信息

Am J Forensic Med Pathol. 2017 Dec;38(4):359-361. doi: 10.1097/PAF.0000000000000348.

Abstract

INTRODUCTION

Dolichoectasia of vertebrobasilar artery is a rare vasculopathy, which is characterized by ectasia, elongation, and tortuosity of the basilar artery.

CASE DESCRIPTION

A 85-year-old man was referred to the Clinic of Neurology with sudden-onset coma. A brain computed tomography scan showed remarkable fusiform dilatation with elongation of basilar artery, with compressive effect on brain stem. Autopsy confirmed existence of vertebrobasilar dolichoectasia, with organized old thrombus and partially with recent occlusive thrombosis. The histology and immunohistochemical staining were showing a loss of the elastic tissue with significant fibrosis in the tunica media and small groups of foam macrophages and cholesterol crystals in atherosclerotic plaque.

CONCLUSIONS

We presented a case of dolichoectasia of vertebrobasilar artery with an obstructive hydrocephalus, due to direct compression on pons and midbrain, which is an extremely rare entity. This case had been analyzed during the patient's life through clinical, laboratory, and radiology examinations and after he died through autopsy.

摘要

引言

椎基底动脉延长扩张症是一种罕见的血管病变,其特征为基底动脉扩张、延长和迂曲。

病例描述

一名85岁男性因突发昏迷被转诊至神经内科诊所。脑部计算机断层扫描显示基底动脉呈明显的梭形扩张并延长,对脑干有压迫作用。尸检证实存在椎基底动脉延长扩张症,伴有机化的陈旧血栓,部分伴有近期闭塞性血栓形成。组织学和免疫组化染色显示中膜弹性组织缺失,伴有显著纤维化,动脉粥样硬化斑块中有小群泡沫巨噬细胞和胆固醇结晶。

结论

我们报告了一例因直接压迫脑桥和中脑导致梗阻性脑积水的椎基底动脉延长扩张症病例,这是一种极其罕见的情况。该病例在患者生前通过临床、实验室和影像学检查进行了分析,并在其死后通过尸检进行了分析。

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