Schianchi P M, Hughes J T
Adv Neurol. 1978;20:521-34.
A group of 20 necropsies of subarachnoid hemorrhage (SAH) were selected because of the known complication of cerebral vasospasm. Evidence for vasospasm was radiological and pathological in 17 cases and pathological alone in 3 cases. A histological examination of the large arteries in areas known formerly to be in spasm showed that in the 13 early cases (death before 3 weeks) there were relevant changes in all layers of the arterial wall, the most significant being a degeneration of the media and elastica. In the 7 late cases (death after 3 weeks), in addition to the sequelae of the acute changes, there was marked concentric intimal thickening; and the localization was again in the particular segments of arteries formerly in spasm. Changes found in the small arteries, capillaries, and veins in the early and the late cases were thought to be caused by the ischemia due to the vasospasm. These changes were also seen in control material.
选取了一组20例因已知有脑血管痉挛并发症的蛛网膜下腔出血（SAH）尸检病例。17例有血管痉挛的证据为放射学和病理学表现，3例仅有病理学表现。对先前已知发生痉挛区域的大动脉进行组织学检查发现，在13例早期病例（死亡发生在3周前）中，动脉壁各层均有相关改变，最显著的是中膜和弹性膜变性。在7例晚期病例（死亡发生在3周后）中，除了急性改变的后遗症外，还有明显的同心性内膜增厚；且病变再次出现在先前发生痉挛的动脉特定节段。早期和晚期病例中小动脉、毛细血管和静脉的改变被认为是由血管痉挛导致的缺血引起的。在对照材料中也观察到了这些改变。
