Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis
Introduction. Pathomorphological studies allow verifying clinical data concerning diagnostic features and predictors of ischemic strokes. Small number and inconsistency of such works have determined the objective of this study: to refine morphological markers of basic pathogenic of ischemic strokes...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Research Center of Neurology
2018-12-01
|
| Series: | Анналы клинической и экспериментальной неврологии |
| Subjects: | |
| Online Access: | https://annaly-nevrologii.com/journal/pathID/article/viewFile/544/434 |
| _version_ | 1811338042797981696 |
|---|---|
| author | Pavel L. Anufriev Marine M. Tanashyan Tat'yana S. Gulevskaya Anna N. Evdokimenko |
| author_facet | Pavel L. Anufriev Marine M. Tanashyan Tat'yana S. Gulevskaya Anna N. Evdokimenko |
| author_sort | Pavel L. Anufriev |
| collection | DOAJ |
| description | Introduction. Pathomorphological studies allow verifying clinical data concerning diagnostic features and predictors of ischemic strokes. Small number and inconsistency of such works have determined the objective of this study: to refine morphological markers of basic pathogenic of ischemic strokes in cerebral atherosclerosis.
Materials and methods. We conducted pathomorphological study of 114 cases of ischemic stroke, as well as histological, ultrastructural and immunohistochemical examinations of 20 carotid atherosclerotic plaques (ASB) removed in carotid endarterectomy.
Results. In most cases, morphological markers of strokes in cerebral atherosclerosis were particular degrees of isolated (70%) or tandem (50%) atherostenosis, as well as one or more small or medium-size infarctions in the areas of adjacent blood supply or deep regions of the brain hemispheres, cerebellum and brainstem. In occlusive atherothrombosis and arterio-arterial embolism, 98% of strokes were characterized by the development of large or medium cortical-subcortical infarction in certain vascular regions, and the presence of atherothrombotic occlusion or complicated ASB in combination with distal embolic occlusion on the side of an ischemic lesion. High frequency of the occurrence of ASB with unstable structure complicated by thrombosis, and combination of every second major recent infarction caused by thrombosis with silent small organized ischemic foci in the same blood pool as a result of stenosis were established. Significant direct relationship was found between expression of von Willebrand factor and morphological signs of carotid atherosclerosis activity (p0.017), whereas the degree of expression of other endothelial substances did not correlate with structural changes in ASB.
Conclusions. We showed potentiality for differential diagnosis of various pathogenic variants of strokes associated with atherosclerotic narrowing and complicated pathology of cerebral arteries, as well as the role of silent infarctions, unstable ASB and von Willebrand endothelial factor as predictors of cerebral atherosclerosis complications. |
| first_indexed | 2024-04-13T18:05:04Z |
| format | Article |
| id | doaj.art-ecaccb9f3dfb47a7ab795a84b1a4ce8e |
| institution | Directory Open Access Journal |
| issn | 2075-5473 2409-2533 |
| language | English |
| last_indexed | 2024-04-13T18:05:04Z |
| publishDate | 2018-12-01 |
| publisher | Research Center of Neurology |
| record_format | Article |
| series | Анналы клинической и экспериментальной неврологии |
| spelling | doaj.art-ecaccb9f3dfb47a7ab795a84b1a4ce8e2022-12-22T02:36:06ZengResearch Center of NeurologyАнналы клинической и экспериментальной неврологии2075-54732409-25332018-12-01124162210.25692/ACEN.2018.4.2416Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosisPavel L. Anufriev0Marine M. Tanashyan1Tat'yana S. Gulevskaya2Anna N. Evdokimenko3Research Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyResearch Center of NeurologyIntroduction. Pathomorphological studies allow verifying clinical data concerning diagnostic features and predictors of ischemic strokes. Small number and inconsistency of such works have determined the objective of this study: to refine morphological markers of basic pathogenic of ischemic strokes in cerebral atherosclerosis. Materials and methods. We conducted pathomorphological study of 114 cases of ischemic stroke, as well as histological, ultrastructural and immunohistochemical examinations of 20 carotid atherosclerotic plaques (ASB) removed in carotid endarterectomy. Results. In most cases, morphological markers of strokes in cerebral atherosclerosis were particular degrees of isolated (70%) or tandem (50%) atherostenosis, as well as one or more small or medium-size infarctions in the areas of adjacent blood supply or deep regions of the brain hemispheres, cerebellum and brainstem. In occlusive atherothrombosis and arterio-arterial embolism, 98% of strokes were characterized by the development of large or medium cortical-subcortical infarction in certain vascular regions, and the presence of atherothrombotic occlusion or complicated ASB in combination with distal embolic occlusion on the side of an ischemic lesion. High frequency of the occurrence of ASB with unstable structure complicated by thrombosis, and combination of every second major recent infarction caused by thrombosis with silent small organized ischemic foci in the same blood pool as a result of stenosis were established. Significant direct relationship was found between expression of von Willebrand factor and morphological signs of carotid atherosclerosis activity (p0.017), whereas the degree of expression of other endothelial substances did not correlate with structural changes in ASB. Conclusions. We showed potentiality for differential diagnosis of various pathogenic variants of strokes associated with atherosclerotic narrowing and complicated pathology of cerebral arteries, as well as the role of silent infarctions, unstable ASB and von Willebrand endothelial factor as predictors of cerebral atherosclerosis complications.https://annaly-nevrologii.com/journal/pathID/article/viewFile/544/434ischemic strokecerebral infarctioncerebral atherosclerosispathomorphological examination |
| spellingShingle | Pavel L. Anufriev Marine M. Tanashyan Tat'yana S. Gulevskaya Anna N. Evdokimenko Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis Анналы клинической и экспериментальной неврологии ischemic stroke cerebral infarction cerebral atherosclerosis pathomorphological examination |
| title | Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| title_full | Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| title_fullStr | Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| title_full_unstemmed | Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| title_short | Morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| title_sort | morphological markers of basic pathogenic variants of ischemic strokes in cerebral atherosclerosis |
| topic | ischemic stroke cerebral infarction cerebral atherosclerosis pathomorphological examination |
| url | https://annaly-nevrologii.com/journal/pathID/article/viewFile/544/434 |
| work_keys_str_mv | AT pavellanufriev morphologicalmarkersofbasicpathogenicvariantsofischemicstrokesincerebralatherosclerosis AT marinemtanashyan morphologicalmarkersofbasicpathogenicvariantsofischemicstrokesincerebralatherosclerosis AT tatyanasgulevskaya morphologicalmarkersofbasicpathogenicvariantsofischemicstrokesincerebralatherosclerosis AT annanevdokimenko morphologicalmarkersofbasicpathogenicvariantsofischemicstrokesincerebralatherosclerosis |