Ferrer Isidro, Vidal Noemi
Pathologic Anatomy Service, Institute of Neuropathology, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain.
Pathologic Anatomy Service, Institute of Neuropathology, Bellvitge University Hospital, University of Barcelona, Barcelona, Spain.
Handb Clin Neurol. 2017;145:79-114. doi: 10.1016/B978-0-12-802395-2.00007-9.
The chapter describes the epidemiology of cerebrovascular diseases, anatomy of the cerebral blood vessels, pathophysiology of ischemia, hypoxia, hypoxemia, anemic hypoxia, histotoxic hypoxia, carbon monoxide damage, hyperoxid brain damage and decompression sickness, and selective cell and regional vulnerability; diseases of the blood vessels including atherosclerosis, hypertensive angiopathy, small vessel disease, inflammatory vascular diseases, cerebral amyloid angiopathies, CADASIL, CARASIL and other diseases that can lead to cerebrovascular occlusion; intracranial and intraspinal aneurysms and vascular malformations; hematologic disorders that can cause cerebral infarct or hemorrhage; brain ischemic damage; and spontaneous intracranial bleeding. Within ischemic brain damage, focal cerebral ischemia, hemorrhagic infarct, brain edema, penumbra, global cerebral ischemia, venous thrombosis, lacunas and lacunar state, status cribosus, granular atrophy of the cerebral cortex, hippocampal sclerosis, vascular leukoencephalopathy Binswanger type and multi-infarct encephalopathy are discussed in detail. Cognitive impairment of vascular origin deserves an individual section.
本章介绍了脑血管疾病的流行病学、脑血管理解剖学、缺血、缺氧、低氧血症、贫血性缺氧、组织中毒性缺氧、一氧化碳损伤、过氧化脑损伤和减压病的病理生理学,以及选择性细胞和区域易损性;血管疾病,包括动脉粥样硬化、高血压性血管病、小血管疾病、炎症性血管疾病、脑淀粉样血管病、伴有皮质下梗死和白质脑病的常染色体显性遗传性脑动脉病(CADASIL)、伴有视网膜病和白质脑病的常染色体隐性遗传性脑动脉病(CARASIL)以及其他可导致脑血管闭塞的疾病;颅内和脊髓内动脉瘤及血管畸形;可引起脑梗死或出血的血液系统疾病;脑缺血损伤;以及自发性颅内出血。在缺血性脑损伤中,详细讨论了局灶性脑缺血、出血性梗死、脑水肿、半暗带、全脑缺血、静脉血栓形成、腔隙和腔隙状态、筛状状态、大脑皮质颗粒性萎缩、海马硬化、宾斯旺格型血管性白质脑病和多发性梗死性脑病。血管源性认知障碍值得单独一节论述。