Histological Study of the Normal Vertebral Artery-Etiology of Dissecting Aneurysms-

Sato, Taku; Sasaki, Tatsuya; Suzuki, Koichi; Matsumoto, Masato; Kodama, Namio; Hiraiwa, Kouichi

doi:10.2176/nmc.44.629

Cited by 38 publications

(27 citation statements)

References 24 publications

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“…3,[14][15][16]21,28) The subsequent healing process for cerebral dissecting aneurysms presenting with SAH and exhibiting neointimal proliferation is assumed to occur after 2 weeks. 13,14) Although the process might require more than a month, depending on the extent of the wall injury, rebleeding at more than a month after the onset of SAH is rare.…”

Section: Discussionmentioning

confidence: 99%

Long-Term Follow Up of Antegrade Recanalization of Vertebral Artery Dissecting Aneurysm After Internal Trapping -Case Report-

Kojima

Okui

Onozuka

2010

Neurol. Med. Chir.(Tokyo)

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A 34-year-old female presented with subarachnoid hemorrhage caused by the rupture of a right vertebral artery (VA) dissecting aneurysm. The affected site, including the aneurysm and parent artery, was successfully occluded with detachable coils. Follow-up angiography performed 28 days after the endovascular treatment revealed recanalization of the parent artery. We decided to treat the patient conservatively without further intervention because the aneurysm had been completely occluded. Magnetic resonance imaging showed a normal VA configuration with a minor irregularity of the affected wall at 6 years after onset. Rebleeding tends to occur during the acute stage because spontaneous healing of the dissecting vascular wall typically occurs within one month after onset. Our case suggests that additional intervention is unnecessary during the chronic stage once the aneurysm has been occluded and no further signs of the development of VA dissection are found.

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Section: Discussionmentioning

confidence: 99%

Long-Term Follow Up of Antegrade Recanalization of Vertebral Artery Dissecting Aneurysm After Internal Trapping -Case Report-

Kojima

Okui

Onozuka

2010

Neurol. Med. Chir.(Tokyo)

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“…Overall, we detected 32 IEL defects in 21 normal BAs, which is similar to the rate reported by us for normal VAs. 12) IEL defects in normal BAs were frequently located near the VA junction and the BA bifurcation.…”

Section: Histology Of the Normal Vbamentioning

confidence: 97%

“…8,16) We therefore studied the presence, absence, and distribution of the internal elastic lamina (IEL), and the condition of the intima at the site of IEL defects. 12) Materials were obtained from 10 autopsy cases, and 20 VAs were examined histologically. The excised VA from the extradural to the intracranial segment was cut at 5-mm intervals, and each segment was fixed in formalin and embedded in paraffin.…”

Section: Histology Of the Normal Vbamentioning

confidence: 99%

“…7) To investigate the reasons for the high incidence of injury to the vertebral artery (VA), the most frequent site of dissecting aneurysms, we histologically examined normal and dissected VBAs. 12) Based on the results, we discuss the medico-legal issues of the causal relationship between external force applied and rupture or dissection of the VA.…”

Section: Introductionmentioning

confidence: 99%

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Medico-legal Aspects of Traumatic Injury of the Vertebrobasilar Artery

Hiraiwa

Sato

Sasaki

et al. 2005

Neurol. Med. Chir.(Tokyo)

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Based on our experiences with medico-legal autopsies, we analyzed traumatic injury of the vertebrobasilar artery (VBA) in traffic accident victims. VBA rupture occurred in six cases with traumatic medullary lesions, but in none with cervical cord injury. A relatively small external force applied to the head or neck can induce isolated traumatic subarachnoid hemorrhage (SAH), which accounts for approximately 11% of fatal head injuries. We examined the relationship between site of impact and site of vascular injury in 16 cases of isolated traumatic SAH. The results showed that the vertebral artery (VA) on the side of impact tended to be longitudinally injured in victims experiencing an external force equivalent to that of a fist punch to the head or face. There was no clear relationship between the site of impact and the site of vascular injury in victims who had sustained an external force greater than that of a fist punch. However, our results suggest that an external force causing rotation of the head was likely to cause tearing of the artery. In cases in which an external force equivalent to that of a fist punch was applied to the head, a raised blood alcohol level was a significant risk factor for artery rupture. Furthermore, a difference in the diameters of the left and right VAs was a risk factor for artery rupture. To determine why the VA, the most frequent site of arterial dissection, is also frequently the site of injury, we histologically examined normal and dissected VBAs. We also discuss medico-legal issues of the causal relationship between external force applied and rupture or dissection of the VA.

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“…Most of the DVBAs in group 1 did not show morphologic findings in the vessel wall. Sato et al 11 showed that disrupted internal elastic lamina, covered with intimal thickening, is commonly found at postmortem examination in normal intracranial vertebral arteries of patients who died of causes other than intracranial lesions. Most of the incidentally detected lesions occurred silently or with minor headache and vessel wall healing occurred silently.…”

Section: Morphologic Changesmentioning

confidence: 99%