Pathomorphological changes of the vascular bed and the state of collateral blood flow in cerebral infarction
DOI:
https://doi.org/10.14739/2310-1237.2020.2.212808Keywords:
pathology, cerebral infarction, vascular bed, collateral blood flowAbstract
The aim of the study. To study the pathomorphological changes of the vascular bed and the state of collateral blood flow in cerebral infarction.
Materials and methods. The brains of 45 deceased patients with hemispheric infarctions with different terms of the disease were studied during the work. The comparison group consisted of 10 patients who died suddenly from acute coronary insufficiency, who did not have diseases of the nervous system.
To assess the morpho-functional state of blood vessels and the intensity of blood flow the cross-sectional area of blood vessels, the area of endothelial cell nuclei, the density of their location and the length of the capillary network were determined.
Results. In the early stages of stroke, along with the processes of irreversible damage of small capillaries in the area of infarction and partly in the area of the penumbra, myocardial thrombosis and constant number of vessels in the perifocal area of infarction, there are processes aimed at providing effective blood flow in ischemic areas of brain by increasing collateral blood flow from the leptomeningeal vessels, increasing the diameter of blood vessels and the length of the capillary network. On the 6th day of the disease, the processes of collagenization of the subarachnoid space are registered, which reduced the collateral blood flow from the pial vessels to the underlying cortical parts of the brain. With the increasing of the disease duration, the diameter of the capillaries returns to initial values, in the perifocal areas of the infarct there is a recalibration of the lumen of the arterioles with a decrease in the total cross-sectional area of newly formed vessels, a significant number of arterioles with obliteration of the lumen are present.
Conclusions. In the early stages of ischemic stroke there is an increase in blood circulation due to an increase in the diameter of the capillaries, the length of the capillary network and increased collateral circulation by the pial vessels. In the long-term period there is a reduction in the total area of the lumen of arterioles and a decrease in the efficiency of collateral blood flow, which should be regarded as an adaptive response of the vascular bed to decreased need for blood supply to stroke areas at the stage of cyst formation.
References
Katan, M., & Luft, A. (2018). Global Burden of Stroke. Seminars in neurology, 38(2), 208-211. https://doi.org/10.1055/s-0038-1649503
Yang, Q., Tong, X., Schieb, L., Vaughan, A., Gillespie, C., Wiltz, J. L., King, S. C., Odom, E., Merritt, R., Hong, Y., & George, M. G. (2017). Vital Signs: Recent Trends in Stroke Death Rates - United States, 2000-2015. MMWR. Morbidity and mortality weekly report, 66(35), 933-939. https://doi.org/10.15585/mmwr.mm6635e1
Yin, K. J., Hamblin, M., & Chen, Y. E. (2015). Angiogenesis-regulating microRNAs and Ischemic Stroke. Current vascular pharmacology, 13(3), 352-365. https://doi.org/10.2174/15701611113119990016
Kanazawa, M., Takahashi, T., Ishikawa, M., Onodera, O., Shimohata, T., & Del Zoppo, G. J. (2019). Angiogenesis in the ischemic core: A potential treatment target?. Journal of cerebral blood flow and metabolism, 39(5), 753-769. https://doi.org/10.1177/0271678X19834158
Seto, S. W., Chang, D., Jenkins, A., Bensoussan, A., & Kiat, H. (2016). Angiogenesis in Ischemic Stroke and Angiogenic Effects of Chinese Herbal Medicine. Journal of clinical medicine, 5(6), 56. https://doi.org/10.3390/jcm5060056
Hatakeyama, M., Ninomiya, I., & Kanazawa, M. (2020). Angiogenesis and neuronal remodeling after ischemic stroke. Neural regeneration research, 15(1), 16-19. https://doi.org/10.4103/1673-5374.264442
Nishihiro, S., Hishikawa, T., Hiramatsu, M., Kidani, N., Takahashi, Y., Murai, S., Sugiu, K., Higaki, Y., Yasuhara, T., Borlongan, C. V., & Date, I. (2019). High-Mobility Group Box-1-Induced Angiogenesis After Indirect Bypass Surgery in a Chronic Cerebral Hypoperfusion Model. Neuromolecular medicine, 21(4), 391-400. https://doi.org/10.1007/s12017-019-08541-x
Alves, H. C., Pacheco, F. T., & Rocha, A. J. (2016). Collateral blood vessels in acute ischemic stroke: a physiological window to predict future outcomes. Arquivos de neuro-psiquiatria, 74(8), 662-670. https://doi.org/10.1590/0004-282X20160050
Ginsberg, M. D. (2018). The cerebral collateral circulation: Relevance to pathophysiology and treatment of stroke. Neuropharmacology, 134(Pt B), 280-292. https://doi.org/10.1016/j.neuropharm.2017.08.003
Zhang, H., Chalothorn, D., & Faber, J. E. (2019). Collateral Vessels Have Unique Endothelial and Smooth Muscle Cell Phenotypes. International journal of molecular sciences, 20(15), 3608. https://doi.org/10.3390/ijms20153608
Okell, T. W., Harston, G., Chappell, M. A., Sheerin, F., Kennedy, J., & Jezzard, P. (2019). Measurement of collateral perfusion in acute stroke: a vessel-encoded arterial spin labeling study. Scientific reports, 9(1), 8181. https://doi.org/10.1038/s41598-019-44417-7
Lima, F. O., Furie, K. L., Silva, G. S., Lev, M. H., Camargo, E. C., Singhal, A. B., Harris, G. J., Halpern, E. F., Koroshetz, W. J., Smith, W. S., Yoo, A. J., & Nogueira, R. G. (2010). The pattern of leptomeningeal collaterals on CT angiography is a strong predictor of long-term functional outcome in stroke patients with large vessel intracranial occlusion. Stroke, 41(10), 2316-2322. https://doi.org/10.1161/STROKEAHA.110.592303
Madelung, C. F., Ovesen, C., Trampedach, C., Christensen, A., Havsteen, I., Hansen, C. K., & Christensen, H. (2018). Leptomeningeal collateral status predicts outcome after middle cerebral artery occlusion. Acta neurologica Scandinavica, 137(1), 125-132. https://doi.org/10.1111/ane.12834
Okyere, B., Creasey, M., Lebovitz, Y., & Theus, M. H. (2018). Temporal remodeling of pial collaterals and functional deficits in a murine model of ischemic stroke. Journal of neuroscience methods, 293, 86-96. https://doi.org/10.1016/j.jneumeth.2017.09.010
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (SeeThe Effect of Open Access).
