Antunović Vaso, Mirčić Aleksandar, Marinković Slobodan, Brigante Luciano, Mališ Miloš, Georgievski Biljana, Aksić Miljana
Clinical Center of Montenegro, University of Podgorica, Podgorica, Montenegro.
Institute of Histology and Embryology, Faculty of Medicine, University of Belgrade, Serbia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2017 Dec 1;38(3):19-29. doi: 10.2478/prilozi-2018-0003.
There is scarce data in the contemporary literature regarding the correlation of the microanatomy of the perforating arteries, their atherosclerosis, and the ischemia in their territory. In order to examine, at least partially, those parameters, the perforating arteries of 12 brains were microdissected or their vascular casts were obtained. In addition, 30 specimens of the perforators were used for a histological and immunohistochemical study. Finally, radiological images of 14 patients with deep cerebral infarcts were examined following a selection among 62 subjects. It was found out that certain groups of the perforators ranged in number between 0 to 11 (1.1-8.4 on average). In addition to the origin from the parent vessels, some of the perforators also arose from the leptomeningeal branches. Occlusion of such a branch may result in both a superficial and a deep ischemic lesion. Besides, the common stems of certain perforators supplied both right and left portions of the corresponding brain regions. Occlusion of such a common trunk leads to bilateral infarction. The atherosclerosis of the perforating vessels, which was found in one third of the specimens, is the basis for the ischemic lesions development on their territory. Among the 62 patients with ischemic lesions, 14 had a deep cerebral infarcts, most often within the thalamus, as well as on the territory of the middle cerebral and the anterior choroidal artery perforators of the hemispheres. Our study showed that a strong correlation exists between certain microanatomical features, atherosclerosis, and region of supply of the perforating arteries, on the one hand, and location of the ischemic lesions on the other hand.
当代文献中关于穿支动脉的微观解剖结构、动脉粥样硬化及其供血区域缺血之间的相关性数据稀少。为了至少部分地研究这些参数，对12个大脑的穿支动脉进行了显微解剖或获取了其血管铸型。此外，使用了30个穿支标本进行组织学和免疫组织化学研究。最后，在62名受试者中进行筛选后，检查了14例深部脑梗死患者的放射学图像。结果发现，某些组的穿支数量在0至11之间（平均为1.1 - 8.4）。除了起源于母血管外，一些穿支还起源于软脑膜分支。阻塞这样的分支可能导致浅表和深部缺血性病变。此外，某些穿支的共同干供应相应脑区的左右部分。阻塞这样的共同主干会导致双侧梗死。在三分之一的标本中发现的穿支血管动脉粥样硬化是其供血区域缺血性病变发展的基础。在62例有缺血性病变的患者中，14例有深部脑梗死，最常见于丘脑以及半球大脑中动脉和脉络膜前动脉穿支的供血区域。我们的研究表明，一方面，穿支动脉的某些微观解剖特征、动脉粥样硬化和供血区域与另一方面的缺血性病变位置之间存在密切相关性。
