Ishikawa T, Nakamura N, Houkin K, Nomura M
Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, Japan.
Neurosurgery. 1997 Feb;40(2):403-5; discussion 405-6. doi: 10.1097/0006123-199702000-00038.
Although the incidence is low, a very small aneurysm with a thin wall and no neck arises at the superior wall of the supraclinoid portion of the internal carotid artery and is called a "blister-like" aneurysm. However, the pathogenesis of such a vascular lesion remains uncertain.
A 57-year-old man developed a fatal subarachnoid hemorrhage caused by the rupture of a blister-like aneurysm at the superior wall of the internal carotid artery. An autopsy was performed, and the lesion was pathologically examined.
The internal elastic lamina and media had disappeared at the border between the eccentrically sclerotic and normal carotid wall. The gap in the internal elastica was covered with normal adventitia and fibrinous tissue. This portion was not composed of collagenous tissue as ordinarily seen in an aneurysmal wall. Neither infiltration of inflammatory cells nor dissection of the artery were observed.
The blister-like aneurysm appeared to be a laceration of the carotid wall based on degeneration of the internal elastic lamina.
尽管发病率较低，但颈内动脉床突上段上壁会出现一种壁薄且无颈部的极小动脉瘤，称为“水泡样”动脉瘤。然而，这种血管病变的发病机制仍不明确。
一名57岁男性因颈内动脉上壁水泡样动脉瘤破裂导致致命性蛛网膜下腔出血。进行了尸检，并对病变进行了病理检查。
在偏心硬化的颈动脉壁与正常颈动脉壁的交界处，内弹性膜和中膜消失。内弹性膜的间隙被正常外膜和纤维组织覆盖。该部分并非由动脉瘤壁中常见的胶原组织构成。未观察到炎性细胞浸润或动脉夹层。
基于内弹性膜退变，水泡样动脉瘤似乎是颈动脉壁的撕裂伤。
