Hughes J T, Schianchi P M
J Neurosurg. 1978 Apr;48(4):515-25. doi: 10.3171/jns.1978.48.4.0515.
From a larger series of autopsies with subarachnoid hemorrhage (SAH), 20 cases were selected for the known complication of cerebral vasospasm. Evidence for vasospasm was radiological and pathological in 17 cases and pathological alone in three. A systematic histological examination of the large arteries in places known formerly to have been in spasm showed that, in the 12 early cases (death before 3 weeks), there were relevant changes in all the layers of the arterial wall, the most significant being evidence of necrosis in the tunica media. In the eight late cases (death after 3 weeks), in addition to the sequelae of the earlier acute changes, there was marked concentric intimal thickening by subendothelial fibrosis, again located in the segments of arteries formerly in spasm. Changes were also found in the small arteries, capillaries, and veins, both in the early and late cases but these changes, although striking, were thought to be caused by the ischemia due to the vasospasm; similar changes were also seen in the control cases with ischemia from arterial occlusion.
从一系列规模更大的蛛网膜下腔出血（SAH）尸检病例中，选取了20例已知发生脑血管痉挛并发症的病例。17例有血管痉挛的影像学和病理学证据，3例仅有病理学证据。对先前已知发生痉挛部位的大动脉进行系统组织学检查发现，在12例早期病例（死亡发生在3周前）中，动脉壁各层均有相关变化，最显著的是中膜出现坏死迹象。在8例晚期病例（死亡发生在3周后）中，除了早期急性变化的后遗症外，还出现了明显的内膜同心性增厚，伴有内皮下纤维化，同样位于先前发生痉挛的动脉节段。在早期和晚期病例的小动脉、毛细血管和静脉中也发现了变化，但这些变化虽然显著，但被认为是由血管痉挛导致的缺血引起的；在因动脉闭塞导致缺血的对照病例中也观察到了类似变化。
