Document Detail


Saccular intracranial aneurysm: pathology and mechanisms.
MedLine Citation:
PMID:  22249619     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Saccular intracranial aneurysms (sIA) are pouch-like pathological dilatations of intracranial arteries that develop when the cerebral artery wall becomes too weak to resist hemodynamic pressure and distends. Some sIAs remain stable over time, but in others mural cells die, the matrix degenerates, and eventually the wall ruptures, causing life-threatening hemorrhage. The wall of unruptured sIAs is characterized by myointimal hyperplasia and organizing thrombus, whereas that of ruptured sIAs is characterized by a decellularized, degenerated matrix and a poorly organized luminal thrombus. Cell-mediated and humoral inflammatory reaction is seen in both, but inflammation is clearly associated with degenerated and ruptured walls. Inflammation, however, seems to be a reaction to the ongoing degenerative processes, rather than the cause. Current data suggest that the loss of mural cells and wall degeneration are related to impaired endothelial function and high oxidative stress, caused in part by luminal thrombosis. The aberrant flow conditions caused by sIA geometry are the likely cause of the endothelial dysfunction, which results in accumulation of cytotoxic and pro-inflammatory substances into the sIA wall, as well as thrombus formation. This may start the processes that eventually can lead to the decellularized and degenerated sIA wall that is prone to rupture.
Authors:
Juhana Frösen; Riikka Tulamo; Anders Paetau; Elisa Laaksamo; Miikka Korja; Aki Laakso; Mika Niemelä; Juha Hernesniemi
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2012-01-17
Journal Detail:
Title:  Acta neuropathologica     Volume:  123     ISSN:  1432-0533     ISO Abbreviation:  Acta Neuropathol.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-24     Completed Date:  2012-09-24     Revised Date:  2012-11-12    
Medline Journal Info:
Nlm Unique ID:  0412041     Medline TA:  Acta Neuropathol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  773-86     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Helsinki University Central Hospital, Topeliuksenkatu 5, 00260 Helsinki, Finland. juhana.frosen@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Aneurysm, Ruptured / etiology,  metabolism,  pathology*
Animals
Cerebral Arterial Diseases / etiology,  metabolism,  pathology
Humans
Inflammation / pathology
Intracranial Aneurysm / metabolism,  pathology*
Oxidative Stress
Thrombosis / pathology
Comments/Corrections
Comment In:
Radiologe. 2012 Sep;52(9):801-2   [PMID:  22930098 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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