Pathological Studies on the Intracerebral and Retinal Arteries in Cerebrovascular and Noncerebrovascular Diseases

Abstract

Abstract• Histological examinations of the intracerebral and retinal arteries were performed in patients who had cerebrovascular disease and in those cases who did not. Fibrinoid degeneration, fibrous nodule, and splitting, which are most frequently found in putamen, thalamus and pons, are thought to be the main changes in cerebral hemorrhage and infarction. Fibrous and fibro-hyalinoid thickenings of the retinal arteries were found mainly in the neighboring region of the optic disk, which reflects the changes of the intracerebral arteries. Hyalinoid thickening was found in the ora serrata, which does not reflect the changes of the intracerebral arteries.Our results suggest that patients with these retinal artery changes in the region near the optic disk, if moderate to severe, have an increased risk of having or incurring cerebral hemorrhage and infarction, but the arterial changes in the ora serrata do not always indicate risk of cerebral hemorrhage and infarction. Additional Key Wordscerebral hemorrhage fibrinoid degeneration cerebral infarction splitting fibrous nodule putamen pons atherosclerosis thalamus hypertension• The significance of the changes of the retinal arteries in various disorders, particularly cerebrovascular diseases, has been of interest to physicians, and controversy exists as to whether the degenerative changes of the intracerebral arteries are parallel to those of the retinal arteries. Several attempts have been made to show the relationship between the changes of these arteries. 15 However, the comparative analyses of the changes between intracerebral and retinal arteries were not sufficient.The purpose of this paper is to describe the intracerebral and retinal vascular changes in various types of cerebrovascular diseases (CVD) in the Japanese and the relationship of various degenerative changes between intracerebral and retinal arteries. MethodsHistological examinations were performed in 22 patients with cerebrovascular diseases. Of these, 11 patients (age range: 37 to 76 years with an average of 58 years) had cerebral hemorrhage. There were eight cases with cerebral infarction (age range: 62 to 85 years with an average of 73 years). The remaining three cases had subarachnoid hemorrhage, their ages being 29, 68 and 75 years. An additional 21 cases without cerebrovascular diseases (non-* Present address: Department of Neurology, Neurological Institute, Kyushu University, Faculty of Medicine, Fukuoka City, Japan 812 (reprint requests).tSecond Department of Internal Medicine, and {Department of Ophthalmology, Kyushu University, Faculty of Medicine, Fukuoka City, Japan 812. CVD) were studied (age range: 21 to 69 years with an average of 49 years). An age-matched control study was performed in 12 cases (cerebral hemorrhage in nine, and cerebral infarction in three) with an age range from 37 to 68 years (average of 57 years), and in 12 non-CVD cases, ranging in age from 37 to 69 years (average of 57 years).In each case 15 samples were taken of the basal ganglia at levels through the mamillary...

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