Expanded ischemic lesion due to herniation leads to axonal injury in a site remote to the primary lesion on autopsy brain with acute focal cerebral ischemia.

IF 1.3 4区 医学 Q4 CLINICAL NEUROLOGY
Neuropathology Pub Date : 2023-10-01 Epub Date: 2023-02-28 DOI:10.1111/neup.12900
Erika Seki, Takashi Komori, Nobutaka Arai
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引用次数: 0

Abstract

Cerebral ischemia may lead to axonal injury not only at the site of the primary lesion but also in a region remote to the site of insult. In this study, we investigated the effect of herniation on the development of axonal injury at a site remote to the primary lesion during the acute phase of cerebral ischemia. We obtained postmortem brains of 13 cases with acute phase of unilateral cerebral infarction in the territory of the internal carotid artery or middle cerebral artery and seven controls. We classified the brain tissues into herniation and non-herniation groups. Then we examined whether axonal and ischemic changes existed in the corpus callosum contralateral to the ischemic hemisphere and the upper pons. In the herniation group, we detected white-matter lesions by Klüver-Barrera staining, microglial loss by immunohistochemistry for ionized calcium-binding adaptor molecule 1, and axonal injury by immunohistochemistry for amyloid precursor protein. However, none of the aforementioned findings were observed in the non-herniation group. These findings suggest the existence of regional overlap in axonal and ischemic pathologies in remote regions in the presence of herniation. We concluded that herniation may play a significant role in the development of axonal and ischemic changes in the remote region. Our results suggest that axonal injury in a remote region may result from expanded ischemic lesions due to herniation.

急性局灶性脑缺血尸检大脑中,由于疝引起的扩大性缺血性病变导致远离原发病变的轴突损伤。
脑缺血不仅可能导致原发病变部位的轴突损伤,而且可能导致远离损伤部位的区域的轴突损伤。在这项研究中,我们研究了脑缺血急性期脑疝对远离原发病变部位轴突损伤发展的影响。我们获得了13例颈内动脉或大脑中动脉区域单侧脑梗死急性期患者和7名对照者的死后大脑。我们将脑组织分为脑疝组和非脑疝组。然后,我们检查了缺血性半球对侧的胼胝体和上桥脑是否存在轴突和缺血性变化。在疝症组中,我们通过Klüver-Barrera染色检测白质病变,通过免疫组织化学检测电离钙结合接头分子1的小胶质细胞损失,通过免疫组化检测淀粉样蛋白前体蛋白的轴突损伤。然而,在非脑疝组中没有观察到上述发现。这些发现表明,在存在疝的偏远地区,轴突和缺血性病理存在区域重叠。我们得出结论,疝可能在远端区域轴突和缺血性变化的发展中发挥重要作用。我们的研究结果表明,偏远地区的轴突损伤可能是由疝引起的缺血性病变扩大引起的。
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来源期刊
Neuropathology
Neuropathology 医学-病理学
CiteScore
4.10
自引率
4.30%
发文量
105
审稿时长
6-12 weeks
期刊介绍: Neuropathology is an international journal sponsored by the Japanese Society of Neuropathology and publishes peer-reviewed original papers dealing with all aspects of human and experimental neuropathology and related fields of research. The Journal aims to promote the international exchange of results and encourages authors from all countries to submit papers in the following categories: Original Articles, Case Reports, Short Communications, Occasional Reviews, Editorials and Letters to the Editor. All articles are peer-reviewed by at least two researchers expert in the field of the submitted paper.
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