Friedman P, Magidson M
Surg Neurol. 1982 Jan;17(1):71-6. doi: 10.1016/0090-3019(82)90049-0.
Angiographically demonstrated arterial luminal narrowing after operations for intracranial aneurysms is a well-documented phenomenon. However, the mechanisms responsible for neurological dysfunction in the presence of vasospasm have not been clearly defined. Destructive changes have been demonstrated within the walls of vasospastic vessels. These changes consist of desquamation of endothelium and thrombus formation, necrosis of smooth muscle cells, and repair by connective tissue proliferation. A 50-year-old man with two aneurysms on the right carotid artery postoperatively developed ischemic symptoms and on angiography was shown to have multiple intraluminal filling defects and vasospasm. Ephemeral intraluminal thrombus is postulated as the inciting cause of morbidity in cerebral vasospasm in some cases.
血管造影显示颅内动脉瘤手术后动脉管腔狭窄是一种有充分文献记载的现象。然而，血管痉挛时导致神经功能障碍的机制尚未明确。已证实在血管痉挛血管壁内存在破坏性改变。这些改变包括内皮细胞脱落和血栓形成、平滑肌细胞坏死以及结缔组织增生修复。一名50岁男性，右侧颈动脉有两个动脉瘤，术后出现缺血症状，血管造影显示有多个管腔内充盈缺损和血管痉挛。在某些情况下，短暂的管腔内血栓被认为是脑血管痉挛发病的诱因。
