Benhaïem-Sigaux N, Gray F, Gherardi R, Roucayrol A M, Poirier J
Département d'Histologie-Embryologie-Biologie cellulaire, Faculté de Médecine Paris-Val de Marne, Hôpital Henri Mondor, Créteil, France.
Stroke. 1987 Nov-Dec;18(6):1087-92. doi: 10.1161/01.str.18.6.1087.
An 80-year-old hypertensive woman developed right hemiplegia and died 24 hours after admission. Neuropathologic examination revealed multiple cerebral infarcts of various ages and diffuse subcortical arteriosclerotic encephalopathy. Clusters of asymptomatic "expanding" lacunes, due to dilatation of the perivascular spaces, were found in both dentate nuclei. These cavities, which presented as space-occupying lesions, were surrounded by a single layer of flattened cells and contained 1 or more sections of normal-looking arterioles. Such a topographic grouping of lacunes in the dentate nucleus has not been described previously. The mechanism of widening of the perivascular compartment remains unclear; its occurrence in a hypertensive patient and its association with typical Binswanger's subcortical arteriosclerotic encephalopathy and severe atherosclerosis with multiple infarcts suggest a common pathophysiologic mechanism possibly including an alteration of the blood-brain barrier.
一名80岁的高血压女性出现右侧偏瘫，入院24小时后死亡。神经病理学检查发现了不同时期的多发性脑梗死以及弥漫性皮质下动脉硬化性脑病。在双侧齿状核中发现了由于血管周围间隙扩张导致的无症状“扩大”腔隙群。这些腔隙表现为占位性病变，被单层扁平细胞所包围，并包含1条或更多条外观正常的小动脉分支。齿状核中这种腔隙的地形学分组此前尚未见报道。血管周围间隙增宽的机制仍不清楚；其在高血压患者中的出现及其与典型的宾斯旺格皮质下动脉硬化性脑病以及伴有多发性梗死的严重动脉粥样硬化的关联提示可能存在一种共同的病理生理机制，可能包括血脑屏障的改变。
