scholarly journals Pathology of Spontaneous Dissection of Intracranial Arteries

1987 ◽  
Vol 14 (S1) ◽  
pp. 88-91 ◽  
Author(s):  
John H.N. Deck
Keyword(s):  
Internal Carotid ◽  
Cerebral Arteries ◽  
Internal Elastic Lamina ◽  
Cystic Medial Necrosis ◽  
Vertebrobasilar System ◽  
Moya Moya Disease ◽  
Medial Necrosis ◽  
The Media ◽  
And Control ◽  
Spontaneous Dissection

ABSTRACT:Spontaneous dissection of a major subarachnoid artery is an uncommon cause of stroke in young and apparently healthy individuals. Such dissection does not correlate well with systemic conditions such as emboli, thrombotic or hemorrhagic tendencies or hypertension, nor with disease of blood vessels such as atherosclerosis, fibromuscular dysplasia, cystic medial necrosis or Moya-Moya disease. Unusual exertion has been implicated as a factor in some cases. Gap defects were found in the internal elastic lamina near the site of dissection in three of four cases of spontaneous dissection reported here. It is suggested that such defects, because of their unusual size or number, may be responsible for initiating dissection in susceptible individuals. A detailed study of the major cerebral arteries in cases of dissection and control cases to document the size and frequency of such defects could shed light on the pathogenesis of spontaneous dissection. The subsequent course of events tends to differ in the internal carotid and vertebro-basilar systems. In most cases, the dissection in the internal carotid system is sub-intimal leading to thrombosis and cerebral infarction, while in the vertebrobasilar system dissection lies between the media and adventitia leading to subarachnoid hemorrhage. It is not known what structural differences of the two arterial systems may underlie this difference in the pattern of arterial dissection.

DIFFICULTIES IN DIAGNOSING MOYA-MOYA DISEASE (CLINICAL CASE)

2020 ◽  
pp. 48-53
Author(s):  
Novikova I.N. ◽  
Popova T.F. ◽  
Gribacheva I.A. ◽  
Petrova E.V. ◽  
Marushchak A.A. ◽  
...  
Keyword(s):  
Cerebral Angiography ◽  
Neurological Disorders ◽  
Clinical Case ◽  
Carotid Arteries ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Moya Moya Disease ◽  
Middle Cerebral Arteries ◽  
Internal Carotid Arteries ◽  
Made In

Moya-Moya disease is a rare progressive chronic cer-ebrovascular disease characterized by a narrowing of the lumen of the intracranial segments of the internal carotid arteries, as well as the initial segments of the anterior and middle cerebral arteries with the devel-opment of a network of small vascular anastomoses. Violations of blood supply due to occlusion lead to the development of ischemic strokes in the correspond-ing pools, and ruptures of vascular anastomoses - to the development of hemorrhagic strokes, causing a variety of neurological disorders. The article presents a clinical case of Moya-Moya disease in a 31-year-old patient. The disease was manifested by acute disorders of cerebral circulation in ischemic and hemorrhagic types. The diagnosis was made in accordance with the diagnostic criteria of the disease based on the data of endovascular cerebral angiography.

scholarly journals Moyamoya Disease is a Progressive Occlusive Arteriopathy of the Primitive Internal Carotid Artery

2003 ◽  
Vol 9 (1) ◽  
pp. 39-45 ◽  
Author(s):  
M. Komiyama
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Moyamoya Disease ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Clinical Manifestations ◽  
External Carotid ◽  
Vertebrobasilar System ◽  
Pharyngeal System ◽  
The Relationship

The purpose of this literature review is to disclose the relationship between the temporal profile of steno-occlusive changes in the cerebral arteries in moyamoya disease and the embryological evolution of the cerebral arteries. Steno-occlusive changes and progression occur in the sequence of embryological evolution of the primitive internal carotid artery in the early embryological stage. In other words, steno-occlusive changes in the cerebral arteries occur primarily near the bifurcation of the cranial and caudal divisions of the primitive internal carotid artery, evolve from the cranial division to the caudal one, and progress from the bifurcation centrifugally. Steno-occlusive changes do not occur essentially in the distal cortical branches of the primitive internal carotid artery, in any arteries in the external carotid system, which are derived from ventral pharyngeal system and primitive stapedial system, or in any cerebral arteries in the vertebrobasilar system, which are derived from the longitudinal neural arteries. These facts suggest that moyamoya disease is strongly related to the vasculogenesis of the primitive internal carotid artery and genetic factors play a major role in the clinical manifestations of moyamoya disease.

Microsurgical Anatomy of the Dural Arteries

2005 ◽  
Vol 56 (suppl_4) ◽  
pp. ONS-211-ONS-251 ◽  
Author(s):  
Carolina Martins ◽  
Alexandre Yasuda ◽  
Alvaro Campero ◽  
Arthur J. Ulm ◽  
Necmettin Tanriover ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Foramen Magnum ◽  
Reciprocal Relationship ◽  
External Carotid ◽  
Microsurgical Anatomy ◽  
Vertebrobasilar System ◽  
Accurate Treatment ◽  
The Individual

Abstract OBJECTIVE: The objective was to examine the microsurgical anatomy basic to the microsurgical and endovascular management of lesions involving the dural arteries. METHODS: Adult cadaveric heads and skulls were examined using the magnification provided by the surgical microscope to define the origin, course, and distribution of the individual dural arteries. RESULTS: The pattern of arterial supply of the dura covering the cranial base is more complex than over the cerebral convexity. The internal carotid system supplies the midline dura of the anterior and middle fossae and the anterior limit of the posterior fossa; the external carotid system supplies the lateral segment of the three cranial fossae; and the vertebrobasilar system supplies the midline structures of the posterior fossa and the area of the foramen magnum. Dural territories often have overlapping supply from several sources. Areas supplied from several overlapping sources are the parasellar dura, tentorium, and falx. The tentorium and falx also receive a contribution from the cerebral arteries, making these structures an anastomotic pathway between the dural and parenchymal arteries. A reciprocal relationship, in which the territories of one artery expand if the adjacent arteries are small, is common. CONCLUSION: The carotid and vertebrobasilar arterial systems give rise to multiple branches that supply the dura in a complex and overlapping pattern. A knowledge of the microsurgical anatomy of these dural arteries and their assessment on pretreatment evaluations plays a major role in safe and accurate treatment of multiple lesions.

MOYA MOYA DISEASE- A REVIEW

2017 ◽  
Vol 10 (4) ◽  
pp. 14 ◽  
Author(s):  
Kollu Vnr Aishwarya ◽  
Ratnam Kv
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Collateral Circulation ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Genetic Studies ◽  
Secondary Bleeding ◽  
Moya Moya Disease ◽  
Cerebrovascular Occlusive Disease ◽  
The Brain

Moya moya syndrome is a specific chronic cerebrovascular occlusive disease first reported by Japanese surgeons in 1957. The disease moya moya, which is a Japanese mimetic word, gets its characteristic name due to the appearance of puff of smoke on relevant angiographs resultant from the tangle of tiny vessels in response to stenosis. This makes the blood to leak out of the arteries, causing pressure to the brain. It may cause ischemic attacks or cerebal infarction, which is more frequent in children than in adults. The highest peak is in childhood at less than 10 years of age. The disease causes constrictions primarily in the internal carotid artery, and often extends to the middle and anterior cerebral arteries, branches of the internal carotid artery inside the skull. When the internal carotid artery becomes completely blocked, the fine collateral circulation that it supplies is obliterated. The clinical features are strokes, recurrent transient ischemic attacks (TIAs), sensorimotor paralysis (numbness and paralysis of the extremities), convulsions and/or migraine -like headaches. Moreover, following a stroke, secondary bleeding may occur. Such bleeding, called hemorrhagic strokes.Treatment with perivascular sympathectomy and superior cervical ganglionectomy. Etiology of the disease is still unknown; however, multifactorial inheritance is considered possible because of a higher incidence of the disease in Japanese and Koreans and approximately 10% of familial occurrence among the Japanese. Recent genetic studies suggest some responsible genetic foci in chromosomes 3, 6 and 17.Keywords: Moyamoya disease, Intracranial hemorrhage, Proteomics, Stenosis.

scholarly journals Isolated Dissection of the Ductus Arteriosus Associated with Sudden Unexpected Intrauterine Death

2021 ◽  
Vol 8 (8) ◽  
pp. 91
Author(s):  
Marny Fedrigo ◽  
Silvia Visentin ◽  
Paola Veronese ◽  
Ilaria Barison ◽  
Alessia Giarraputo ◽  
...  
Keyword(s):  
Smooth Muscle ◽  
Drug Therapy ◽  
Ductus Arteriosus ◽  
Intrauterine Death ◽  
Cystic Medial Necrosis ◽  
Descending Aorta ◽  
Medication Consumption ◽  
Medial Necrosis ◽  
The Media ◽  
Muscle Cell Apoptosis

We report five cases of sudden intrauterine death due to premature closure of the ductus arteriosus. In four cases, this was caused by dissecting the hematoma of the ductus arteriosus with intimal flap and obliteration of the lumen. In one case, the ductus arteriosus was aneurysmatic, with lumen occlusion caused by thrombus stratification. No drug therapy or free medication consumption were reported during pregnancy. The time of stillbirth ranged between 26 and 33 gestational weeks. We performed TUNEL analysis for apoptosis quantification. The dissecting features were intimal tears with flap formation in four of the cases, just above the origin of the ductus arteriosus from the pulmonary artery. The dissecting hematoma of the ductus arteriosus extended downward to the descending aorta and backward to the aortic arch with involvement of the left carotid and left subclavian arteries. TUNEL analysis showed a high number of apoptotic smooth muscle cells in the media in two cases. Abnormal ductal remodeling with absence of subintimal cushions, lacunar spaces rich in glycosaminoglycans (cystic medial necrosis), and smooth muscle cell apoptosis were the pathological substrates accounting for failure of remodeling process and dissection.

scholarly journals Spontaneous Dissection of Cervico-Cerebral Arteries

1978 ◽  
Vol 5 (1) ◽  
pp. 9-19 ◽  
Author(s):  
C. Miller Fisher ◽  
Robert G. Ojemann ◽  
Glenn H. Roberson
Keyword(s):  
Facial Pain ◽  
Internal Carotid ◽  
Cerebral Arteries ◽  
Correct Diagnosis ◽  
Transient Ischemic Attacks ◽  
Vertebral Arteries ◽  
Transient Monocular Blindness ◽  
The Mean ◽  
Spontaneous Dissection ◽  
Cervical Internal Carotid Artery

SUMMARY:Sixteen cases of spontaneous dissection of the cervical internal carotid artery (6 verified) are described. The mean age was 45 years. The clinical picture varied from simply headache and a bruit to hemiplegia and aphasia. Eleven patients had transient ischemic attacks. Headache, facial pain, a subjective bruit, oculo-sympathetic palsy and transient monocular blindness were present in various combinations in two-thirds of cases and their presence suggested the correct diagnosis. Examples of suspected dissection of the intracranial internal carotid, middle cerebral, posterior cerebral and extracranial vertebral arteries are also presented. Spontaneous dissection is more common than the literature indicates.

Spontaneous Dissection of Three Major Coronary Arteries Subsequent to Cystic Medial Necrosis

CHEST Journal ◽  
1999 ◽  
Vol 116 (5) ◽  
pp. 1473-1475 ◽  
Author(s):  
Viviane M. Conraads ◽  
Anne Vorlat ◽  
Cecile G. Colpaert ◽  
Inez E. Rodrigus ◽  
Rudi J. De Paep ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Cystic Medial Necrosis ◽  
Medial Necrosis ◽  
Spontaneous Dissection

scholarly journals Extracranial Internal Carotid Artery Aneurysm due to Cystic Medial Necrosis

1984 ◽  
Vol 24 (11) ◽  
pp. 891-896
Author(s):  
Yoshihiro ITO ◽  
Takafumi KODAMA ◽  
Jun-ichi KURATSU ◽  
Yasuhiko MATSUKADO ◽  
Hiroshi HAYAKAWA
Keyword(s):  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
Artery Aneurysm ◽  
Extracranial Internal Carotid Artery ◽  
Cystic Medial Necrosis ◽  
Carotid Artery Aneurysm ◽  
Internal Carotid Artery Aneurysm ◽  
Medial Necrosis

Abstract T P419: Pathological Arterial Wall Correlates of Lumen-based Remodeling: Results From the Brain Arterial Remodeling Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Jose Gutierrez ◽  
Mitchell S Elkind ◽  
James Goldman ◽  
Lawrence Honig ◽  
Susan Morgello ◽  
...  
Keyword(s):  
Vascular Disease ◽  
Arterial Wall ◽  
Cerebral Arteries ◽  
Internal Elastic Lamina ◽  
Cross Sectional ◽  
Luminal Stenosis ◽  
The Media ◽  
The Relationship ◽  
The Brain ◽  
Elastic Lamina

Background: There is paucity of data about arterial wall characteristics of the smallest and largest caliber cerebral vessels. Determining the relationship between the lumen and the wall might shed new insights into cerebral artery remodeling. Objective: To test the hypotheses that arteries with larger luminal diameters have a thinner wall and that arteries with the smallest lumina have thicker walls. Methods: Cross-sectional segments from large arteries (N=1392) were obtained from the circle of Willis in 196 autopsied brains (mean age 55 ± 17 yrs, 39% with hypertension, 15% with diabetes and 20% with dyslipidemia). Lumen diameter, stenosis percentage, and thicknesses of intima, media, and adventitia were calculated in digital microphotography after staining. Atheromas and internal elastic lamina (IEL) disruption were rated visually. Arteries were categorized into the top 5% (“dilated”) and bottom 5% (“narrowed”) of the luminal diameters, as well as an intermediate category (90% of sample as reference). We used logistic regression to obtain the odds of association (OR, 95% CI) after adjusting for demographic and vascular variables. Results: Narrowed arteries were more frequently found in men (OR 2.7, 95%CI 1.3-5.9) and with dyslipidemia (4.2, 1.6-11.1) while dilated arteries were more frequently found in women (5.6, 2.2-14.0), in smokers (2.6, 1.0-6.5) and those with prior MI (7.7, 1.2-48.7). Narrowed arteries were more likely to have atheromas (20.8, 4.8-90.3), greater luminal stenosis (per %, 1.1, 1.1-1.2), thicker vessel walls (1.3, 1.2-1.4), but thinner medias (0.9, 0.8-1.0). Conversely, larger arteries exhibited less IEL disruption (0.3, 0.1-0.9), atheromas (0.34, 0.1-0.9) and stenosis (0.8, 0.8-0.9), their walls were thinner (0.8, 0.8-0.9) but the media was thicker (1.1, 1.1-1.2). Conclusions: Narrowed cerebral arteries were more likely to have atheromas while dilated arteries had thinner walls and were more frequent in subjects with prior MI. These findings suggest that both extremes of the arterial spectrum might be differentially related with vascular disease, underscoring the need to revisit whether standard preventive measures for vascular disease are equally effective in patients harboring such disparate arterial phenotypes.

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