実験的クモ膜下出血後の攣縮脳血管壁における微細構造の経時的変化
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概要
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Sequential ultrastructural changes in the canine basilar artery in experimental vasospasms were examined by means of electron microscopy. To induce vasospasm, 5 ml of fresh isologous arterial blood was injected through the optic canal into the basal cistern. Angiographically the vasospasm occurred in a biphasic fashion. Early vasospasms occurred immediately after injection of the fresh blood and lasted for about 1 to 2 hours. Late vasospasms appeared about 2 to 3 hours after the injection of the fresh blood and continued for about 7 days. In the early vasospasms, no ultrastructural change of the basilar artery was observed in electron microscopy level, whereas narrowing of the lumen with corrugation of internal elastica could be seen in light microscopy. In the late vasospasms, the ultrastructural changes of the intima and adventitia preceded those of the media, which were striking between 24 hours and 3 days after injection of fresh blood. In the intima, endothelial cells were swollen, became more vivid under the microscopy and contained intracytoplasmic vacuoles of various sizes. Marked loss of tight junctions was observed. The internal elastica appeared to be swollen and showed less electron density. In the media, smooth muscle cells showed diminution and fragmentation of myofibrils and disruption of sarcolemma, and contained vacuoles of various sizes and degenerated organelles. The interstitial areas were edematous. In the adventitia, fibrocytes exhibited pyknosis of varying degrees. Occasional axons of nerve fibers became condensed and lost their structures. Myelin sheaths were markedly disfigured. Two weeks after injection of fresh blood when the blood clot in the subarachnoid space vanished and there was angiographically no evidence of vasospasm, the endothelial cells assumed a normal configuration with intact tight junctions, and the adventitia appeared normal. Six months later, however, many smooth muscular cells still contained numerous dense bodies.
- 日本脳神経外科学会の論文
- 1980-03-15