Kim C, Cervós-Navarro J, Kikuchi H, Hashimoto N, Hazama F
Neurosurgical Clinic, Nordstadt Hospital, Hannover, Federal Republic of Germany.
Acta Neurochir (Wien). 1993;121(1-2):76-81. doi: 10.1007/BF01405187.
In order to investigate the developmental mechanism of saccular cerebral aneurysms, changes in the internal elastic lamina at the junction of the anterior cerebral artery and the olfactory artery were electronmicroscopically studied in 6 control and 6 experimental rats undergoing ligation of the left carotid artery and branches of both renal arteries. In the control group, spontaneous destructive changes occurred on the luminal side of the internal elastic lamina and progressed from the luminal towards the abluminal side as the elastic lamina advanced to the apex. Close to the apex, these changes invaded and disrupted the whole elastic lamina. The elastic lamina was replaced by sparsely lined up lumps of elastic tissue in the walls of early aneurysmal alterations, and was atrophied and disappeared totally in the walls of aneurysmal alterations that had reached an advanced stage. These spontaneous changes were in agreement with reports in the literature and our own previous investigations. From the findings in the experimental rats it becomes likely that the aneurysmal changes in the elastic lamina are exaggerated forms of the normal catabolic metabolism. Therefore its synthesis on the abluminal side no longer balances with the catabolism on the luminal side. It is strongly suggested that aneurysmal alterations progress from the luminal towards the abluminal side of arterial walls and that the lytic process of elastase might play a role in the degenerative changes in aneurysmal development.
为了研究囊状脑动脉瘤的发育机制，对6只对照大鼠和6只实验大鼠进行了电子显微镜研究，这些实验大鼠结扎了左颈动脉和双侧肾动脉分支，观察大脑前动脉与嗅动脉交界处内弹性膜的变化。在对照组中，内弹性膜的管腔侧出现自发性破坏改变，并随着弹性膜向顶端推进而从管腔侧朝无管腔侧发展。靠近顶端时，这些改变侵入并破坏整个弹性膜。在早期动脉瘤样改变的壁内，弹性膜被排列稀疏的弹性组织团块所取代，而在已发展到晚期的动脉瘤样改变的壁内，弹性膜萎缩并完全消失。这些自发性改变与文献报道及我们自己先前的研究结果一致。从实验大鼠的研究结果来看，弹性膜的动脉瘤样改变很可能是正常分解代谢的夸张形式。因此，其在无管腔侧的合成不再与管腔侧的分解代谢保持平衡。强烈提示动脉瘤样改变从动脉壁的管腔侧向无管腔侧发展，并且弹性蛋白酶的溶解过程可能在动脉瘤发展的退行性改变中起作用。
