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[Cervico-cerebral atheroma]
1Service d'Anatomopathologie, Hôpital Saint-Antoine, Paris.
Insights
Atherosclerosis, a major cause of death, affects large arteries like the aorta and cerebral arteries. Its exact causes remain unknown, with only risk factors currently manageable.
Area of Science:
- Cardiovascular Science
- Pathology
Context:
- Atherosclerosis is the primary cause of mortality in developed nations.
- It predominantly impacts large and medium-sized arteries, including the aorta, coronary, and cerebral arteries.
- The arterial intima is the primary site of atherosclerotic lesions.
Purpose:
- To describe the characteristics and common locations of atherosclerotic lesions.
- To outline the potential complications associated with atheromatous plaques.
- To highlight the current lack of understanding regarding the disease's etiology.
Summary:
- Atherosclerosis involves lipid striae and heterogeneous atheromatous plaques within the arterial intima.
- Complications include arterial lumen stenosis, plaque hemorrhage, ulceration, calcification, thrombus organization, and aneurysm formation.
- Predilection sites include extracranial carotid and vertebral arteries, and intracranial cerebral arteries.
Impact:
- Understanding lesion characteristics and locations aids in diagnosing and managing atherosclerosis.
- Identifying potential complications is crucial for preventing severe cardiovascular events.
- Recognizing the unknown etiology emphasizes the importance of managing modifiable risk factors.
Abstract:
Atherosclerosis is the leading cause of death in economically developed countries. The arteries most frequently affected are the aorta, coronary and cerebral arteries. Atherosclerosis only affects large and medium calibre arteries of the general circulation. The lesion involves the arterial intima. The two lesions usually described are lipid striae and atheromatous plaques. The lesions are heterogeneous and it is difficult to correlate them to each other. Atheromatous plaque may be complicated by several types of independent or combined lesions: stenosis of the arterial lumen, haemorrhage into the plaque, ulceration or calcification of the plaque, organisation of a thrombus, aneurysm formation. Lesions predominantly affect the extracranial arteries at the carotid bifurcation and the origin of the vertebral arteries and the cerebral arteries at the origin and termination of the internal carotid artery, the basilar trunk and carotid bulb. The causes of this disease are unknown at the present time. Only the risk factors can be controlled. Pathogenic hypotheses are still highly controversial.