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首页> 外文期刊>Neuropathology: official journal of the Japanese Society of Neuropathology >The hemorrhage caused by sporadic-type cerebral amyloid angiopathy occurs primarily in the cerebral sulci.
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The hemorrhage caused by sporadic-type cerebral amyloid angiopathy occurs primarily in the cerebral sulci.

机译：散发型脑淀粉样血管病引起的出血主要发生在脑沟内。

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摘要

We examined a solitary hematoma in a patient with sporadic cerebral amyloid angiopathy (CAA). The hematoma affected the middle frontal sulcus, cerebral cortex (CC) and subcortical frontal white matter (sfWM). We embedded the hematoma in four paraffin blocks, each of which was cut serially into 6-microm-thick sections. The first section and every 18th section from each block were subjected to Elastica-Goldner (E-G) staining, and the distribution and diameter of the ruptured blood vessels (rBVs) were examined. The rBVs were then marked on diagrams representing each E-G-stained section. The present study yielded the following important findings: (i), early- and recently ruptured Abeta-positive arteries were present mainly in the intrasulcal hematoma (ISH), rather than in the CC; (ii) many early-ruptured arteries in the ISH were larger in diameter than those in the CC; and (iii) ruptures of the cortical arteries, even near the cortical surface, did not occur so frequently and the ruptured vessels were small in size. We concluded that in patients with subcortical hematoma caused by sporadic-type CAA, successive rupturse of the meningeal vessels, mainly arteries, occur in the cerebral sulcus initially, followed by formation of an ISH and development of a fresh hemorrhagic or anemic infarct in the CC surrounding the ISH, the latter in most cases then extending into the brain parenchyma through the necrotic CC at the depth of the sulcus, finally creating a secondary hematoma in the subcortical white matter.
机译：我们检查了散发性脑淀粉样血管病（CAA）患者的孤立性血肿。血肿影响了中额沟，大脑皮层（CC）和皮质下额叶白质（sfWM）。我们将血肿包埋在四个石蜡块中，每个块被依次切成6微米厚的切片。对每个块的第一节和每十八节进行Elastica-Goldner（E-G）染色，并检查破裂血管（rBV）的分布和直径。然后在代表每个E-G染色部分的图表上标记rBV。本研究得出以下重要发现：（i）早期和最近破裂的Abeta阳性动脉主要存在于沟内血肿（ISH）中，而不是在CC中; （ii）ISH中许多早期破裂的动脉的直径大于CC中的那些; （iii）即使在皮层表面附近，皮层动脉的破裂也很少发生，并且破裂的血管很小。我们得出的结论是，由散发型CAA引起的皮层下血肿的患者，最初在脑沟中先后发生脑膜血管（主要是动脉）的连续破裂，随后形成ISH，并在CC中出现新鲜的出血性或贫血性梗塞围绕ISH，在大多数情况下，后者随后在沟深处通过坏死性CC延伸至脑实质，最终在皮层下白质中形成继发性血肿。

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