Charcot-Bouchard aneurysms revisited: clinicopathologic correlations.
Aged
Aged, 80 and over
Arteriosclerosis
/ diagnosis
Atherosclerosis
/ diagnosis
Brain Diseases
/ diagnosis
Cerebral Amyloid Angiopathy
/ complications
Cerebral Hemorrhage
/ complications
Cerebrovascular Circulation
Female
Humans
Hypertension
/ complications
Male
Microaneurysm
/ diagnosis
Middle Aged
Risk Factors
Journal
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
ISSN: 1530-0285
Titre abrégé: Mod Pathol
Pays: United States
ID NLM: 8806605
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
05
04
2021
accepted:
20
05
2021
revised:
20
05
2021
pubmed:
31
7
2021
medline:
19
3
2022
entrez:
30
7
2021
Statut:
ppublish
Résumé
Intracerebral hemorrhage (ICH) is a significant cause of morbidity and mortality worldwide. Hypertension and cerebral amyloid angiopathy (CAA) are the most common causes of primary ICH, but the mechanism of hemorrhage in both conditions is unclear. Although fibrinoid necrosis and Charcot-Bouchard aneurysms (CBAs) have been postulated to underlie vessel rupture in ICH, the role and significance of CBAs in ICH has been controversial. First described as the source of bleeding in hypertensive hemorrhage, they are also one of the CAA-associated microangiopathies along with fibrinoid necrosis, fibrosis and "lumen within a lumen appearance." We describe clinicopathologic findings of CBAs found in 12 patients out of over 2700 routine autopsies at a tertiary academic medical center. CBAs were rare and predominantly seen in elderly individuals, many of whom had multiple systemic and cerebrovascular comorbidities including hypertension, myocardial and cerebral infarcts, and CAA. Only one of the 12 subjects with CBAs had a large ICH, and the etiology underlying the hemorrhage was likely multifactorial. Two CBAs in the basal ganglia demonstrated associated microhemorrhages, while three demonstrated infarcts in the vicinity. CBAs may not be a significant cause of ICH but are a manifestation of severe cerebral small vessel disease including both hypertensive arteriopathy and CAA.
Identifiants
pubmed: 34326486
doi: 10.1038/s41379-021-00847-1
pii: S0893-3952(22)00371-4
pmc: PMC8592842
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2109-2121Informations de copyright
© 2021. The Author(s).
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