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[A comparative study of quantification of morphological changes in intracranial and extracranial arteries between
Insights
Cerebral hemorrhage (CH) and cerebral infarction (CI) patients show significant arterial differences. CH primarily affects small arteries, while CI impacts medium intracranial and extracranial arteries, indicating distinct arteriosclerosis patterns.
Area of Science:
- Neurology
- Pathology
- Vascular Biology
Background:
- Cerebral hemorrhage (CH) and cerebral infarction (CI) are major causes of stroke with distinct underlying pathologies.
- Understanding the differences in arterial changes between CH and CI is crucial for diagnosis and treatment.
- Arteriosclerosis is a common comorbidity in stroke patients, affecting both intracranial and extracranial vessels.
Purpose of the Study:
- To compare pathological changes in intracranial and extracranial arteries between CH and CI.
- To identify similarities and differences in arteriosclerosis severity and location between CH and CI.
- To correlate arterial lesions with specific stroke types.
Main Methods:
- Autopsy study of 120 cases: 42 CH, 58 CI, 20 controls.
- Microscopic examination of medium intracranial arteries, small intracerebral arteries, arterioles, and extracranial carotid arteries.
- Quantitative analysis of lumen area to vessel area (LA-VA) ratio and vessel narrowing using computer assistance.
Main Results:
- Both CH and CI patients exhibited significantly lower LA-VA ratios in intracranial arteries and arterioles compared to controls.
- CH patients showed lower LA-VA ratios in small intracerebral arteries and arterioles than CI patients.
- CI patients had significantly lower LA-VA ratios and more severe atherosclerotic narrowing in medium intracranial arteries and their branches, and extracranial carotid arteries compared to CH patients.
Conclusions:
- Cerebral stroke patients frequently present with atherosclerotic lesions in medium intracranial arteries and sclerotic lesions in small intracerebral arteries and arterioles.
- CH is primarily associated with lesions in small intracerebral arteries and arterioles.
- CI is predominantly linked to lesions in medium-sized intracranial arteries, their branches, and sometimes extracranial carotid arteries.
Abstract:
In order to compare the difference and similarity of the pathological changes in intracranial and extracranial arteries between cerebral hemorrhage (CH) and cerebral Infarction (CI), 120 autopsy cases were studied, including 42 cases of the CH, 58 cases of the CI and 20 cases of cancer as control. Medium sized intracranial arteries and their main branches, small sized intracerebral arteries, arterioles and extracranial carotid arteries (from 14 cases only) were examined with light microscopy. The ratio of lumen area to vessel area (LA-VA ratio) and the degree of narrowing of the vessels indicating the severity of arteriosclerosis were determined. Quantitative analysis was carried out with computer. The results were as follows: (1) The CH and CI patients had significantly lower mean LA-VA ratios of the medium intracranial arteries and their main branches, small intracerebral arteries and arterioles than the controls. (2) The CH patients had apparently lower LA-VA ratio of the small intracerebral arteries and arterioles than the CI patients. (3) The CI patients had significantly lower LA-VA ratio of the medium sized intracranial arteries and their main branches than the CH patients. Moreover, atherosclerotic narrowing of these vessels was also much more severe in the CI than in the CH patients. (4) Atherosclerotic narrowing of the extracranial carotid artery in the CI patients was slightly more severe than that in the CH patients. These data suggest that patients with cerebral stroke have frequently atherosclerotic lesions in the medium sized intracranial arteries and their main branches and sclerotic lesions in the small intracerebral arteries and arterioles. The principal lesion of the CH are in the small intracerebral arteries and arterioles, while those of the CI in the medium sized intracranial arteries and their main branches and sometimes in the extracranial carotid arteries.