Histological differences of the Vascular wall between sites with high and low prevalence of intracranial aneurysm
Laarman, Melanie D.; Ruigrok, Ynte M.; Nierstrasz, Renske C.S.; Spliet, Wim G.M.; Van Hecke, Wim; Algra, Ale; Rinkel, Gabriël J.E.
(2019) Journal of Neuropathology and Experimental Neurology, volume 78, issue 7, pp. 648 - 654
(Article)
Abstract
Intracranial aneurysms (IAs) develop more often on bifurcations compared with the rest of the circle ofWillis (CoW). We investigated histological differences between 2 high IA prevalence sites (anterior communicating artery [AcomA] and basilar tip) and 2 corresponding low IA prevalence sites (anterior cerebral artery [ACA] and basilar artery [BA]) using
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histological sections of 10 CoWs without IAs. Medial defect density in the AcomA was 0.24 medial defects/mm compared with 0.02 for the A1 part and 0.03 for the A2 part of the ACA. In the basilar tip we found 0.15 medial defects/mm compared with 0.14 in the BA. Vascular smooth muscle cells (VSMCs) were more often disorganized in both high-prevalence sites (AcomA: 10/ 10, basilar tip: 5/10) compared with low-prevalence sites (both ACA and BA: 1/10). Intima thickening was more severe in the highprevalence sites. Vascular wall thickness was not significantly different between high- and low-prevalence sites, but had a larger variance in high- compared with low-prevalence sites (AcomA vs ACA: p=6.8E-12, basilar tip vs BA: p=0.02). Disorganized VSMCs at high-prevalence sites likely result in a higher susceptibility to hemodynamic stress, leading to more vascular remodeling (such as intima thickening), which could increase the likelihood of IA formation.
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Keywords: Circle of Willis, Histopathology, Intracranial aneurysm, Vascular remodeling, Pathology and Forensic Medicine, Neurology, Clinical Neurology, Cellular and Molecular Neuroscience
ISSN: 0022-3069
Publisher: Lippincott Williams and Wilkins
Note: Funding Information: Send correspondence to: Ynte M. Ruigrok, MD, PhD, Department of Neurol-ogy and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Heidelberglaan 100, 3584CX Utrecht, The Netherlands; E-mail: ij.m.ruigrok@umcutrecht.nl M.D.L. was supported by the Foundation Friends of the Hubrecht Institute. Publisher Copyright: © 2019 American Association of Neuropathologists, Inc. All rights reserved. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
(Peer reviewed)