Department of Neurosurgery, School of Medicine, Erzincan Binali Yildirim University, Erzincan, Turkey.
Department of Neurosurgery, School of Medicine, Ataturk University, Erzurum, Turkey.
World Neurosurg. 2019 Nov;131:e218-e225. doi: 10.1016/j.wneu.2019.07.124. Epub 2019 Jul 23.
A well-documented association exists between the vasa vasorum and vasopathologies, including atherosclerosis. However, information on the role of the vasa vasorum during vascular degenerative changes of vasospasm after subarachnoid hemorrhage (SAH) is insufficient.
In this study, 34 rabbits were divided into 3 groups: basal group (N = 8), sham group (N = 8), and SAH group (N = 18). Experimental SAH was formed using a double-injection model. During follow-up, the neurologic status of the rabbits was observed. All rabbits were euthanized after 2 weeks, and the vasopathologic degeneration was categorized as normal, mild, moderate, and severe according to the changes in the basilar arteries. The numbers, locations, and spasms of the vasa vasorum and their relation to the vasodegenerative changes of the basilar artery were investigated.
The basilar arteries were graded as normal in the basal and sham groups. In the SAH group, 6 rabbits had mild, 7 had moderate, and 5 had severe degeneration. Neurologic deficits were prominent in the SAH group, and deficit grades correlated with vascular degeneration. The number of the vasa vasorum were significantly higher in the SAH group, and an enhanced formation of the vasa vasorum was noted in which severe degenerative changes were present. Moreover, the vasospasm index of the vasa vasorum, which increased with the aggravation of vascular degenerative changes, was significantly higher in the SAH group.
The vasa vasorum and their vasospasm play a crucial role in the pathogenesis of basilar artery degeneration in the vasospasm following SAH.
血管外膜和血管病变之间存在明确关联，包括动脉粥样硬化。然而，关于蛛网膜下腔出血（SAH）后血管痉挛时血管外膜在血管退行性变化中的作用的信息还不够充分。
本研究将 34 只兔子分为 3 组：基础组（N=8）、假手术组（N=8）和 SAH 组（N=18）。采用双注模型制作实验性 SAH。在随访过程中，观察兔子的神经状态。所有兔子在 2 周后处死，根据基底动脉的变化，将血管病理退行性变分为正常、轻度、中度和重度。研究了血管外膜的数量、位置和痉挛及其与基底动脉血管退行性变化的关系。
基础组和假手术组的基底动脉分级正常。SAH 组中，6 只兔子轻度、7 只中度、5 只重度退行性变。SAH 组的神经功能缺损明显，缺损程度与血管退行性变相关。SAH 组的血管外膜数量明显增加，在严重退行性变化部位观察到血管外膜的形成增强。此外，随着血管退行性变化的加重，血管外膜的血管痉挛指数增加，SAH 组显著升高。
血管外膜及其血管痉挛在 SAH 后血管痉挛时基底动脉退行性变的发病机制中起着关键作用。
