Kim C, Kikuchi H, Hashimoto N, Kojima M, Kang Y, Hazama F
Department of Neurosurgery, Kyoto University Hospital, Japan.
Stroke. 1988 Apr;19(4):507-11. doi: 10.1161/01.str.19.4.507.
To elucidate the role of the internal elastic lamina in the development of cerebral aneurysm, the bifurcation of the anterior cerebral artery and olfactory artery was histologically studied in control and experimental rats treated with unilateral carotid ligation and renal hypertension. Various stages of aneurysm formation were compared, and it was found that early aneurysmal changes were always present just distal to the apical intimal pad on the anterior cerebral artery side. The internal elastic lamina was thinned and fragmented just distal to the pad even in the very early stage of aneurysm formation when the medial layer was still present. In control rats, the internal elastic lamina had a tendency to thin and fragment at the site where aneurysms would develop in experimental rats. Our study shows that changes of the internal elastic lamina were present just distal to the pad even in control rats, which never develop cerebral aneurysms. Under hemodynamic stress augmented by experimental treatments, further degenerative changes of the internal elastic lamina and involvement of the medial layer are considered to occur and result in aneurysm formation there.
为阐明内弹性膜在脑动脉瘤形成中的作用,对接受单侧颈动脉结扎和肾性高血压治疗的对照大鼠和实验大鼠的大脑前动脉与嗅动脉分叉处进行了组织学研究。比较了动脉瘤形成的各个阶段,发现早期动脉瘤变化总是出现在大脑前动脉侧顶端内膜垫的远侧。即使在动脉瘤形成的早期,当中层仍然存在时,内弹性膜在垫的远侧就已经变薄并断裂。在对照大鼠中,内弹性膜在实验大鼠中动脉瘤将形成的部位有变薄和断裂的倾向。我们的研究表明,即使在从未发生脑动脉瘤的对照大鼠中,内弹性膜的变化也出现在垫的远侧。在实验性治疗增强的血流动力学应激下,内弹性膜的进一步退行性变化和中层的累及被认为会发生,并导致动脉瘤在该处形成。