脊椎動脈の法医学および臨床病理学的スペクトル

Michael S Pollanen¹, K A Sarathchandra Kodikara², Fabio A Tironi³

¹Ontario Forensic Pathology Service, Toronto, Ontario, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Canada.

Forensic science international

|September 6, 2025

まとめ

脳卒中や出血などの致命的な脊椎動脈疾患は頸部外傷や遺伝因子と関連していました解剖は両動脈の断片を検査し死因の正確な決定のために遺伝子検査を含めるべきです

科学分野:

法医学病理学
血管病理
遺伝学

背景:

脊椎動脈の損傷は重篤な神経疾患を引き起こす可能性があります脊椎動脈の損傷は重篤な神経疾患を引き起こす可能性があります
基礎的な病理と要因を理解することは正確な法医学と臨床評価に不可欠です

研究の目的:

脊髄動脈を患った 14人の死後の症例の臨床病理学的スペクトルを調査する
脊椎動脈関連の死亡に寄与する根本的な病理と病因的共同因子を特定する.

主な方法:

脊髄動脈の関わりのある14人の死後の検査
頭蓋内と頭蓋の外の脊椎動脈の部位を分析する.
セグメンタル・メディオリティック動脈病変,外傷性破裂,解剖,動脈硬化などの基礎疾患の特定

主要な成果:

ポント・セレベラー心臓発作 (n=8) と亜甲状腺出血 (n=6) が主なアウトカムでした.
セグメンタル・メディオリティック動脈病は,最も頻繁な病理 (n=5) であり,時には上部中枢動脈が関わっていた.
頸部外傷 (50%) と遺伝因子 (21%) が重要な共同因子として特定されました.

結論:

既得 (トラウマ,首の動き) と遺伝的要因の組み合わせが,脊椎動脈の病理に寄与する.
動脈壁の遺伝子の変異は重要なリスク因子であり外部の力に作用します
脊髄動脈の断片,中枢動脈の組織学的検査,遺伝子検査を含む包括的な解剖プロトコルが推奨されます.

キーワード:

動脈解剖カイロプラクティック・ネック操作セグメンタル・メディオリティック動脈病脊椎動脈の破裂

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